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Customer Service Representative II

Company: Centene Corporation
Location: Chesterfield
Posted on: January 4, 2019

Job Description:

Customer Service Representative II Description: Position Purpose\\: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate mannerReference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status mattersProvide assistance to members and/or providers regarding website registration and navigationEducate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiriesDocument all activities for quality and metrics reporting through the Customer Relationship Management (CRM) applicationProcess written customer correspondence and provide the appropriate level of follow-up in a timely mannerResearch and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustmentIdentify trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standardsWork with other departments on cross functional tasks and projects Maintain performance and quality standards based on established call center metrics including turn-around timesQualification: Education/Experience\\: High school diploma or equivalent. Associates degree and claims processing, billing and/or coding experience preferred. 1+years of experience in Medicare, Medicaid managed care or insurance environment preferred. 2+ years of combined customer service experience a and call center environment. Knowledge of managed care programs and services preferred. Depending on the state, bi-lingual skills may also be preferred.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Associated topics: agente de servicio al cliente, call center specialist, client, client service, csr, customer care, customer service representative, product support, service agent, support

Keywords: Centene Corporation, Chesterfield , Customer Service Representative II, Sales , Chesterfield, Missouri

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