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Medical Claim Customer Service Representative Jobs

MagnaCare

Customer Service Representative

$16.50 - $22.25/hr

Customer Service Representative MagnaCare is seeking a fully remote Customer Service Representative ... claims inquiry, claim reconsiderations and appeals. This is a remote position. Primary ...

Pacer Group

Customer Service Representative II

Sanford, FL · On-site

$20 - $21/hr

Customer Service Representative II Location: Remote, FL Duration: 8 months (temp to hire) Shift ... Provide Part, Pump, Motor quotes to customers as required. * Assist with Warranty claim Processing ...

Lincare Holdings

Customer Service Rep

Clearwater, FL · On-site

$14.75 - $20/hr

The Customer Service Rep - CHRG assists with held revenue by collecting required documentation ... medical policies, coverage criteria, and reimbursement guidelines to ensure accurate claim ...

Aespatech

Customer Service Representative

Park City, KY · On-site

$13 - $17.75/hr

Customer Service Representative Site: Louisville, KY Bachelor's degree is MUST Duration: 06 MOnths ... Contact customers to respond to inquiries or to notify them of claim investigation results and any ...

MedReview

Customer Service Representative

Manhattan, NY · On-site

$24.10/hr

Conduct outbound calls to providers to request medical records and supporting documentation ... Familiarity with healthcare claims processing, claim auditing, DRG Validation, Cost Outlier Reviews ...

Clarity Performance

CUSTOMER SERVICE REP

$16.50 - $22.25/hr

Respond to phan call inquiries regarding the processing of a claim. * Research policy information ... Preferred medical terminology and medical claims and coding knowledge. Physical Requirements:

Aespatech

Customer Service Representative

Park City, KY · On-site

$13 - $17.75/hr

Customer Service Representative Site: Louisville, KY Bachelor's degree is MUST Duration: 06 MOnths ... of claim investigation results and any planned adjustments. • Refer unresolved customer ...

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Medical Claim Customer Service Representative information

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$12

$19

$29

How much do medical claim customer service representative jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for medical claim customer service representative in the United States is $19.85, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.63 per hour, depending on experience, location, and employer.

What are popular job titles related to Medical Claim Customer Service Representative jobs?

For Medical Claim Customer Service Representative jobs, the most frequently searched job titles are:

Benefits Customer Service Representative

Metairie, LA • On-site

CCMSI
Insurance Services • 1 - 5K employees
Learn more about CCMSIexternal

$19 - $24/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

CCMSI rating

7.9

Company rating: 7.9 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

Job description

Overview
Benefits Customer Service Representative
Location: Metairie, LA (Onsite)
Schedule: Monday - Friday, 8:00 AM - 4:30 PM (37.5 Hours per Week)
Compensation: $19.00 - $24.00 per hour
Please Note: This is a fully onsite position located in our Metairie, Louisiana office. Remote and hybrid work arrangements are not available for this role.
Build Your Career With Purpose at CCMSI
At CCMSI, we are committed to providing exceptional service and support to our clients, members, and partners. As a certified Great Place to Work® and employee-owned organization, we believe our success starts with dedicated employees who are passionate about helping others.
We foster a collaborative culture where employees are empowered to grow professionally, contribute meaningful ideas, and make a positive impact every day.
Job Summary
The Benefits Customer Service Representative serves as a primary point of contact for members, healthcare providers, insurance carriers, and internal team members regarding group health benefits, eligibility, claims processing, and coverage questions.
This position plays a vital role in delivering exceptional customer service while ensuring members receive accurate information and timely assistance. The successful candidate will interpret benefit plan provisions, research claims issues, support appeals processes, and collaborate with internal teams and external partners to resolve benefit-related concerns.
This role is ideal for someone with health insurance, medical billing, claims processing, benefits administration, or healthcare customer service experience who enjoys helping people navigate complex benefit questions.
Responsibilities
What You'll Do
  • Answer and manage incoming calls related to health benefits, eligibility, claims processing, and coverage questions
  • Serve as a primary resource for members, providers, insurance carriers, and other authorized parties
  • Interpret benefit plan documents, summaries of benefits, and coverage provisions
  • Explain eligibility, deductibles, copayments, exclusions, limitations, coordination of benefits, subrogation, and claim procedures
  • Research claim status inquiries and determine whether claims were processed appropriately
  • Assist with claim denials, payment questions, appeal requests, and benefit explanations
  • Respond to written inquiries related to benefits, eligibility, claims processing, appeals, and coverage questions
  • Research, document, and process appeals in accordance with plan provisions and established deadlines
  • Coordinate with internal staff, medical reviewers, providers, and insurance carriers to resolve member concerns
  • Support annual enrollment activities and enrollment meetings for participating groups
  • Provide backup support to other benefits team members as needed
  • Maintain accurate documentation and records within company systems
  • Ensure compliance with privacy and confidentiality requirements, including handling protected health information appropriately
What Makes Someone Successful in This Role
Successful Benefits Customer Service Representatives are:
  • Customer-focused and service-oriented
  • Detail-oriented and highly organized
  • Comfortable researching and solving problems
  • Able to explain complex benefit information clearly and professionally
  • Effective communicators who remain calm and professional under pressure
  • Accurate and dependable when handling sensitive information
  • Team players who enjoy helping others

Qualifications
Required Qualifications
  • High School Diploma or equivalent
  • Medical terminology knowledge required
  • Minimum two years of experience in one or more of the following:
    • Health insurance
    • Benefits administration
    • Health claims processing
    • Medical billing
    • Customer service within a healthcare environment
  • Strong verbal and written communication skills
  • Strong organizational and time-management skills
  • Ability to research and resolve benefit and claim issues
  • Ability to manage multiple priorities and deadlines
  • Strong attention to detail and accuracy
  • Ability to maintain confidentiality and professionalism
  • Proficiency with Microsoft Office applications, including:
    • Outlook
    • Word
    • Excel
  • Reliable attendance during scheduled business hours
  • Ability to speak to groups of 20-100 attendees for presentations
  • Limited travel required - within the state of Louisiana to conduct benefit enrollment meetings.
Preferred Qualifications
  • Associate degree
  • Experience interpreting health plan documents and benefit structures
  • Experience with medical claims billing, payment, and posting
  • Experience handling benefit appeals
  • Knowledge of medical coding
  • Experience supporting governmental or public entity benefit programs
  • Prior benefits customer service experience

Why You'll Love Working Here
  • 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year
  • Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
  • Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
  • Career growth: Internal training and advancement opportunities
  • Culture: A supportive, team-based work environment

How We Measure Success
At CCMSI, strong Benefits Analysts balance service and accuracy. Success in this role is measured by:
• Customer service quality - clear, timely, and empathetic responses to member and provider inquiries
• Claim accuracy - correct interpretation of plan benefits and claim details
• Productivity & responsiveness - effective handling of calls, inquiries, and assigned work
• Analytical growth - successful cross-training and support of analyst-level tasks
• Compliance & documentation - adherence to client contracts and company standards
• Professionalism & collaboration - reliability, teamwork, and positive client interaction
This is where we shine, and we hire benefits professionals who want to make an impact with us.
Compensation & Compliance
The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.
CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws.
Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.
ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.
Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.
Our Core Values
At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who:
  • Lead with transparency We build trust by being open and listening intently in every interaction.
  • Perform with integrity We choose the right path, even when it is hard.
  • Chase excellence We set the bar high and measure our success. What gets measured gets done.
  • Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
  • Win together Our greatest victories come when our clients succeed.

We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you.
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