Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Case Resolution Specialist I
Honolulu, HI ยท Hybrid
Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Case Resolution Specialist I
Honolulu, HI ยท Hybrid
Triages cases to resolve them upon initial inquiry to best service the member as well as minimize ... Assists with the implementation of resulting decisions for change/resolution. * Assists supervisor ...
Service & Support Specialist
Bronx, NY ยท On-site
Job Title: Service & Support Specialist Project Location Bronx, NY onsite Project Duration ... Leads the service and support team to provide efficient inquiry resolution, develop staff ...
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Service & Support Specialist
Bronx, NY ยท On-site
Job Title: Service & Support Specialist Project Location Bronx, NY onsite Project Duration ... Leads the service and support team to provide efficient inquiry resolution, develop staff ...
Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure ... resolution of outstanding claims Process appeals and claim resubmissions per payer policy and ...
Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure ... resolution of outstanding claims Process appeals and claim resubmissions per payer policy and ...
Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure ... resolution of outstanding claim โข Process appeals and claim resubmissions per payer policy and ...
Reviews assigned accounts perform status inquiry and appeals to 3rd party payers to ensure ... resolution of outstanding claim โข Process appeals and claim resubmissions per payer policy and ...
Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility. 7. Exports and ...
Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility. 7. Exports and ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist I Come join our amazing team and work a hybrid schedule! The Customer ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist I Come join our amazing team and work a hybrid schedule! The Customer ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility. 7. Exports and ...
Teams with Insurance Billing Specialist II and Denial Resolution staff to work projects, request ... Ex: charge corrections, invoice inquiry, billing edits, insurance eligibility. 7. Exports and ...
Hybrid Customer Service Specialist, I
Orange, CA ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Hybrid Customer Service Specialist, I
Orange, CA ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Hybrid Customer Service Specialist, I
Orange, CA ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Hybrid Customer Service Specialist, I
Orange, CA ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Dispute Resolution Consultant
Manhattan, NY ยท On-site
Handles general inquiry calls and website requests; ensures prompt and accurate responses ... for all types of resolution services the company and its Panelists offer; mastery of the ...
Dispute Resolution Consultant
Manhattan, NY ยท On-site
Handles general inquiry calls and website requests; ensures prompt and accurate responses ... for all types of resolution services the company and its Panelists offer; mastery of the ...
Dispute Resolution Consultant
Manhattan, NY ยท On-site
$95K - $125K/yr
Handles general inquiry calls and website requests; ensures prompt and accurate responses ... for all types of resolution services the company and its Panelists offer; mastery of the ...
Dispute Resolution Consultant
Manhattan, NY ยท On-site
$95K - $125K/yr
Handles general inquiry calls and website requests; ensures prompt and accurate responses ... for all types of resolution services the company and its Panelists offer; mastery of the ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Westfield, IN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Hybrid Customer Service Specialist, I
Fullerton, CA ยท Hybrid
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Hybrid Customer Service Specialist, I
Fullerton, CA ยท Hybrid
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Franklin, TN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Customer Service Specialist, I
Franklin, TN ยท On-site
$22/hr
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
The Customer Service Specialist I will be responsible for providing excellent customer service by ... Track, follow-up and complete customer call backs to ensure inquiry resolution. * Collect payments ...
Inquiry Resolution Specialist information
See salary details
$13.46 - $17.31
20% of jobs
$18.22 is the 25th percentile. Wages below this are outliers.
$17.31 - $21.15
20% of jobs
The median wage is $22.80 / hr.
$21.15 - $25
22% of jobs
$25 - $28.85
10% of jobs
$30.77 is the 75th percentile. Wages above this are outliers.
$28.85 - $32.69
5% of jobs
$32.69 - $36.54
5% of jobs
$36.54 - $40.38
4% of jobs
$40.38 - $44.23
2% of jobs
$44.23 - $48.08
0% of jobs
$48.08 - $51.92
5% of jobs
$51.92 - $55.77
5% of jobs
$13
$28
$55
How much do inquiry resolution specialist jobs pay per hour?
What is an Inquiry Resolution Specialist?
How does an Inquiry Resolution Specialist typically collaborate with other departments to resolve complex customer issues?
What are the key skills and qualifications needed to thrive as an Inquiry Resolution Specialist, and why are they important?
What is the difference between Inquiry Resolution Specialist vs Customer Service Representative?
| Aspect | Inquiry Resolution Specialist | Customer Service Representative |
|---|---|---|
| Credentials | High school diploma or equivalent; some roles may require certifications in customer service or conflict resolution | High school diploma or equivalent; customer service training often preferred |
| Work Environment | Call centers, support desks, online chat platforms | Retail stores, call centers, online support |
| Employer & Industry | Telecommunications, tech, finance, retail | Retail, telecom, hospitality, tech |
| Search & Comparison Intent | Understanding role differences, job requirements, career paths | General customer support roles, entry-level positions |
The Inquiry Resolution Specialist focuses on resolving complex customer issues, often requiring specialized knowledge and problem-solving skills. Customer Service Representatives handle a broader range of customer inquiries, including product information and basic support. While both roles involve customer interaction, Inquiry Resolution Specialists typically deal with more complex cases and may require specific certifications, making them more specialized within customer support teams.

Full-time
Posted 12 days ago
Job description
- Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements.
- Secures information from internal and external resources to resolve issues.
- Functions as a liaison with providers, members and internal decision makers in representing HMSA objectives, goals, and expectations for meeting contractual, regulatory, and accreditation requirements.
- Negotiates/resolves sensitive issues with internal and external parties.
- Negotiates fees on behalf of members for non-covered or nonparticipating provider services in addition to soliciting claims and other related medical information from providers in order to resolve member inquiries.
- Takes all facts and research from internal and external resources and presents a full explanation of the member's or provider's position and concerns to management and decision makers.
- Triages cases to resolve them upon initial inquiry to best service the member as well as minimize the number of cases escalated to senior management and executives.
- Participates on cross departmental committees and other internal meetings to identify, clarify, research, and resolve inquiries and issues.
- Identifies when changes to policies and procedures are needed based on case resolutions, statutory or regulatory changes, or accreditation requirements.
- Proposes changes to management based on identification and analysis.
- Analyzes and identifies issues that may require multiple department efforts to resolve.
- Coordinates discussions and meetings to develop processes to resolve those issues.
- Presents recommendations to internal committees, subgroups and executive management for decision making purposes as it relates to cases.
- Assists with the implementation of resulting decisions for change/resolution.
- Assists supervisor/manager in responding to internal investigations, reviews, and audits; regulatory inquiries; and accreditation related audits.
- Assist internal customers with complex member/physician inquiries.
- Assists Supervisor and Coordinator with training.
- Identifies member problems, member education needs, or trends and report these to manager, as well as recommend resolution. Takes a proactive role in reviewing, digesting and communicating any new regulation, standard, business change, etc. affecting the member advocacy and/or appeals process. Assists in the coordination of changes among departments. Assists in determining internal and external impacts.
- Performs quality assurance of case documents and assists Supervisor and Manager with various corporate activities.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
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About Hawaii Medical Service Association
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Honolulu, HI, US
Year founded
1938