Clinical Claims Specialist Position Available In Davidson, Tennessee

Clinical Claims Specialist Devcare Nashville, TN Job Details Full-time | Contract $17 – $22 an hour 23 hours ago Benefits Health insurance Paid time off Qualifications Medicare Managed care Customer service Call center Microsoft Office High school diploma or GED Bachelor’s degree Organizational skills Associate’s degree Communication skills Entry level

Full Job Description Job Summary:

We are seeking a Managed Care Technician with experience in a call center environment, specializing in healthcare insurance, Medicare, and Medicaid. The ideal candidate will handle inbound and outbound calls, assist members with insurance-related inquiries, and provide support for managed care services.

Key Responsibilities:

Handle high-volume inbound and outbound calls related to healthcare insurance, claims, eligibility, benefits, and prior authorizations. Assist members and providers with inquiries regarding Medicare, Medicaid, and commercial insurance plans . Provide exceptional customer service while addressing concerns related to managed care policies and coverage. Process claims, verify patient eligibility, and guide members through the insurance process. Document all interactions accurately in the system and escalate complex cases as needed. Collaborate with internal teams, including case managers and insurance representatives, to ensure timely resolution of issues. Stay updated with healthcare regulations, insurance policies, and managed care programs.

Qualifications & Skills:

Experience:

1-3 years in a call center environment, preferably in healthcare insurance or managed care.

Industry Knowledge:

Strong understanding of Medicare, Medicaid, and commercial health insurance policies.

Communication Skills:

Excellent verbal and written communication skills with a customer-focused approach.

Technical Skills:

Proficiency in MS Office and healthcare systems (e.g., EHR, CRM, or insurance portals).

Problem-Solving:

Ability to handle complex inquiries and resolve issues efficiently.

Education:

High school diploma or equivalent (Associate’s or Bachelor’s degree in healthcare, business, or a related field is a plus).

Preferred Qualifications:

Prior experience working in a managed care organization, health insurance company, or healthcare provider setting .

Job Types:

Full-time, Contract Pay:

$17.00 – $22.00 per hour

Benefits:

Health insurance Paid time off Application Question(s): What is your current location? What is the best way to reach you (Text/Call/Email)?

Experience:

Healthcare Insurance:

1 year (Preferred)

Medicaid:

1 year (Preferred)

Medicare:

1 year (Preferred) Ability to

Commute:

Nashville, TN 37243 (Required)

Work Location:

In person