A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$17.28 per hour Monday - Friday | 8:00 AM - 5:00 PM Got People Skills? Turn Them Into Paychecks Looking for Denials Resolution Representative jobs in Knoxville where great communication makes a real difference? This opportunity lets you assist customers, solve problems, and build positive relationships while helping deliver outstanding service every day. Education Requirements High school diploma or GED required. Additional customer service, business, or office training is beneficial. Experience Requirements Minimum 2 years of medical billing experience required Experience with claim denials and Accounts Receivable preferred Knowledge of physician billing and healthcare reimbursement guidelines Familiarity with ICD-10 and CPT-4 coding Strong computer, organizational, and follow-up skills Excellent verbal and written communication skills Job Duties Review ETM worklists and process claim rejections according to established procedures Research denied and rejected claims and obtain carrier information Identify denial trends and report carrier issues to management Route provider-related rejections to the Provider Enrollment Department Maintain knowledge of the ETM system and denial resolution processes Communicate with supervisors regarding unusual claims, adjustments, and denials Participate in monthly department meetings Perform additional duties as assigned Preferred Qualifications Previous customer service, call center, retail, office support, or administrative experience is preferred. Experience working with CRM software, order processing systems, or customer databases is beneficial. Bilingual communication skills may be considered an asset depending on the position. Individuals who demonstrate patience, professionalism, adaptability, and excellent communication skills are well positioned for success as a Denials Resolution Representative. Physical Capabilities Ability to remain seated or stand for extended periods while assisting customers. Frequent use of computers, telephones, and standard office equipment. Ability to communicate clearly with customers, coworkers, and business partners. Ability to perform repetitive keyboard and data entry tasks throughout the workday. Benefits Competitive Weekly Pay Comprehensive Benefits including medical, dental, and vision coverage. Life Insurance and Disability Insurance for added peace of mind. Optional 401(k) Plan to help you prepare for the future. Supportive Team Environment focused on professional growth and customer success. "The recruiter I worked with was very nice and understanding. They helped me find the job that was best for me." Staffmark Associate Good vibes, good pay, good people. Join us — Apply here. What You Will Do As a Denials Resolution Representative you will assist customers by answering questions, resolving concerns, processing requests, maintaining accurate records, and providing timely follow-up. You will communicate professionally across multiple channels while documenting interactions, supporting internal teams, and helping deliver a positive customer experience through accurate, responsive, and courteous service. A Denials Resolution Representative serves as an important connection between customers and the organization by providing information, resolving concerns, and delivering professional service. This role requires strong communication skills, problem-solving ability, and a genuine commitment to creating positive customer experiences. Successful Denials Resolution Representative professionals listen carefully, communicate clearly, and respond to customer needs with patience and professionalism. They help build trust by providing accurate information, resolving issues efficiently, and maintaining positive relationships. This profession is ideal for individuals who enjoy helping others, solving problems, and contributing to a customer-focused workplace.
