Claims Support/Customer Service Representative

Point Cis a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

The Claims Support / Customer Service Representative plays a key role in supporting Point C’s claims operations by providing exceptional customer service and administrative support. This position is responsible for assisting members, clients, and internal teams with claims-related inquiries, maintaining accurate records, and ensuring timely processing and distribution of documentation. The ideal candidate is detail-oriented, organized, and committed to delivering a high level of service in a fast-paced, collaborative environment.

Primary Responsibilities

• Serve as a first point of contact by answering incoming calls, assisting callers with claims-related inquiries, and routing calls as needed.

• Provide high-quality customer service to members, clients, and internal stakeholders via phone, email, and written correspondence.

• Support claims operations by repricing health claims, creating and distributing documentation, and maintaining accurate databases and records.

• Manage incoming and outgoing correspondence, including mail, faxes, and electronic communications.

• Collect, file, organize, and maintain confidential office and claims-related documents in both physical and digital formats.

• Ensure proper handling of sensitive and encrypted documents in compliance with company policies and privacy requirements.

• Assist with general administrative tasks to support efficient day-to-day office and claims operations.

Qualifications

• Strong written and verbal communication skills, including the ability to actively listen and clearly explain information.

• Excellent organizational and time-management skills with the ability to prioritize tasks and manage multiple responsibilities.

• Demonstrated customer service skills with a professional, positive, and empathetic approach.

• Proficiency with basic computer applications, including word processing, spreadsheets, email, and database systems.

• High attention to detail and accuracy when handling data and documentation.

• Ability to work independently with minimal supervision while also collaborating effectively as part of a team.

• Comprehensive medical, dental, vision, and life insurance coverage
• 401(k) retirement plan with employer match
• Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
• Paid time off (PTO) and disability leave
• Employee Assistance Program (EAP)

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.