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Claims Customer Service Rep I

Claims Customer Service Rep I

Job Locations 
US-VA-Glen Allen
Job ID 

Job Description


The position is responsible for taking incoming provider calls for the Medallion line of business.  Provider issues are to be followed up on within 24 to 48 hours of receipt.  All incoming faxes requesting status of claim are also to be completed within 24 to 48 hours.  


  • Handle all incoming calls quickly and efficiently while delivering quality customer service to the caller.

             Goal = average call length of less than five minutes.
             Goal = 45-55 calls per day

  • Maintain an overall departmental monthly abandonment rate of 5% or less.
  • Identify any trends in calls, denials or other claim related issues by provider/provider group in order to share those findings with Management
  • Handle miscellaneous duties/activities as directed by division Management Team



  • Excellent phone skills.
  • Excellent Customer Service Skills.
  • Strong communication skills (both verbal and written).
  • Ability to work independently as well as with others.
  • Strong organizational skills.
  • Time management skills.

  • Knowledge of CPT-4 coding and ICD-9.
  • Knowledge of various types of medical claims.
  • Ability to conduct research.
  • Analytical and problem-solving skills.



  • Minimum one (1) year experience in medical field or service in a customer service position.
  • Minimum one (1) year experience in claim processing preferred.
  • Knowledge of IDX Claim processing preferred.



  • Physical health sufficient to meet the ergonomic standards and demands of the position


About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 


We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  


All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE


Our mission is to inspire healthy living within the communities we serve!


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