238 Customer Service Representatives jobs in Kenosha

**Job Description**
**Job Summary**
The Provider Claims Adjudicator is responsible for responding to providers regarding issues with claims, coordinating, investigates and confirms the appropriate resolution of claims issues. This role will require actively researching issues to adjudicate claims Requires knowledge of operational areas and systems.
**Knowledge/Skills/Abilities**
+ Facilitates the resolution of claims issues, including incorrectly paid claims, by working with operational areas and provider billings and analyzing the systems.
+ This role is involved in member enrollment, provider information management, benefits configuration and/or claims processing.
+ Responds to incoming calls from providers regarding claims inquiries and provides excellent customer service; documents calls and interactions.
+ Assists in the reviews of state or federal complaints related to claims.
+ Supports the other team members with several internal departments to determine appropriate resolution of issues.
+ Researches tracers, adjustments, and re-submissions of claims.
+ Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards.
+ Manages defect reduction by supporting the identifying and communicating error issues and potential solutions to management.
+ Handles special projects as assigned.
+ Other duties as assigned.
Knowledgeable in systems utilized:
+ QNXT
+ Pega
+ Verint
+ Kronos
+ Microsoft Teams
+ Video Conferencing
+ Others as required by line of business or state
**Job Function**
Provides customer support and stellar service to assist Molina providers with claims inquiries. Leads and resolves issues and addresses needs appropriately and effectively, while demonstrating Molina values in their actions. Responsible for effectively managing and documenting calls and responding to providers regarding issues with claims and inquiries. Handles escalated inquiries, complex provider claims payments, records, and provides counsel to providers. Helps to mentor and coach Provider Claims Adjudicators.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience;
**REQUIRED EXPERIENCE:**
2-3 years customer service, claims, provider and investigation/research experience. Outcome focused and knowledge of multiple systems.
1+ years of claims research and/or issue resolution or analysis of reimbursement methodologies within the managed care health care industry
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
4 years customer service, claims, provider and investigation/research experience.
LTSS claims experience
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in a home or office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $38.37 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**USABlueBook** (a division of HD SUPPLY) is the recognized source of products and technical support for professional water and wastewater operators. As the company founded by utility operators, it is our goal to remain the industry's top technical and customer service leader.
+ **Location:** 3781 Bur Wood Dr, Waukegan, IL 6008cation:
+ **Schedule:** 10:30am-7pm MON-FRI (WEEKENDS OFF)
+ **Pay:** $18hr DOE
+ **Benefits:** Medical, Dental, Vision, Life, 401k, Vacation, Sick Time
+ Proficiency with Microsoft Outlook/Word/Excel
+ Must be able to pass a background/drug test
+ High-Volume Call-Center Experience preferred
**Job Summary**
Provide customer service by responding to inquiries regarding product selection, services and issues. Associates will be responsible for knowledge of 20,000 products and 3 catalogues.
**Major Tasks, Responsibilities, and Key Accountabilities**
+ Responds to customer order and quotation requests received via the telephone, e-mail, written, and faxed correspondence within the department service goals.
+ Performs necessary follow-up to ensure customer service expectations are met.
+ Facilitates profitable growth and the sales process by adherence to department incentive and initiative programs.
+ Researches and suggests alternative products to customers. Provides representation of products, increasing sales wherever appropriate or as requested.
+ Uses computerized system for tracking, information gathering, and/or troubleshooting.
+ Resolves customer issues including issuance of credit concessions.
+ Refers complex, non-standard problems to supervisor.
**Nature and Scope**
+ Selects correct processes from clearly prescribed rules, past practices, or instruction. Seeks advice and guidance on non-routine or problem areas from supervisor. Deviations from the norm are cleared by the supervisor.
+ Under close supervision, exercises limited latitude/independent judgment. Work typically involves detailed checks or close review of output by a senior coworker and/or supervisor.
+ None.
**Work Environment**
+ Located in a comfortable indoor area. Any unpleasant conditions would be infrequent and not objectionable.
+ Most of the time is spent sitting in a comfortable position and there is frequent opportunity to move about. On rare occasions there may be a need to move or lift light articles.
+ No travel required.
**Education and Experience**
+ HS Diploma or GED strongly preferred. 0-2 years of experience in area of responsibility.
**CA, CO, CT, D.C., HI, IL, MA, MD, MN, NJ, NV, NY, OH, RI, VT , WA Job Seekers:**
**Pay Range**
$7.93- 21.49 Hourly
HDS provides the following benefits to all permanent full-time associates:
+ Medical (with Prescription drug coverage), dental, and vision plans
+ Health care and Dependent Care FSA (as applicable)
+ 401(K) with company match
+ Paid Holiday, Vacation, Personal Time, and Wellness Day
+ Paid Sick Time
+ Life and Accidental Death & Dismemberment Insurance
+ Short and Long-term Disability Insurance
+ Critical Illness Insurance
+ Accident Insurance
+ Whole Life insurance
+ Commuter Benefits
+ Tuition Reimbursement
+ Employee Assistance Program
+ Adoption and Surrogacy Assistance
CA, CO, CT, D.C., HI, IL, MA, MD, MN, NJ, NV, NY, OH, RI, VT and WA law requires the posting of the potential salary range for advertised jobs. Individual base pay is determined based on a variety of elements including market data, experience, skills, internal equity and other factors.
**Our Goals for Diversity, Equity, and Inclusion**
We are committed to creating a culture that promotes equity, respect, and advocacy for every HD Supply associate. We value the diversity of our people.
**Equal Employment Opportunity**
HD Supply is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
HD Supply is an Equal Opportunity Minority/Female/Individuals with Disabilities/Protected Veteran and Affirmative Action Employer. HD Supply considers for employment and hires qualified candidates without regard to age, race, religion, color, sex, sexual orientation, gender, gender identity, national origin, ancestry, citizenship, protected veteran or disability status or any factor prohibited by law.