Senior Healthcare and Insurance Operations Representative

HC & Insurance Operations Senior Rep. Job Responsibilities: Review claim rules and workflows Reviews claim requests to determine eligibility for processing and escalate to management on a case to case basis Organizing and completing tasks per assigned priorities Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving complex situations following pre-established guidelines Desired Skills & Qualification: University degree or equivalent that required 3+ years of formal studies Possess excellent typing skill Ability to understand logic of standard Payment posting (i.e. Payment, Denials, Adjustments etc.) 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. Ability to work scheduled shifts from Monday-Friday 07:30 PM to 05:30 AM and to be flexible to accommodate business requirements Ability to communicate (oral/written) effectively in English to exchange information with our client. Experience Level Senior Level