: Customer Service Representative
- To increase satisfaction, retention, and growth by efficiently delivering competitive services to members or providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.
- Handle customer service inquiries and problems via telephone, internet and, or written correspondence in a professional courteous manner. Quickly read and reinterpret information to caller(s) in a manner that meets their level of comprehension with or without scripts.
- Experience in a production environment or a transaction based environment such as a call center or like setting in behavioral or medical healthcare is preferred.
- Customer Service experiences is required
- Answers questions and resolves issues based on phone calls/letters from members, providers, and internal customers.
- Documents and tracks contacts with members, providers and internal customers appropriately.
- Is vigilant in identifying possible compliance/ethics issues and reports any concerns to manager/supervisor, Medicaid Compliance Officer, internal legal counsel or Alert Line.
- Handles customer service inquiries and problems via telephone, internet or written correspondence.
- Customer inquiries are related to but not limited to health care claims, eligibility, authorizations, appeals and disputes, contracting, web portal inquiries, etc.