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Customer Service Representative II

Company: Centene Coproration
Location: Des Moines
Posted on: February 15, 2020

Job Description:

Description: Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters Provide assistance to members and/or providers regarding website registration and navigation Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application Process written customer correspondence and provide the appropriate level of follow-up in a timely manner Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment Identify 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 standards Work with other departments on cross functional tasks and projects Maintain performance and quality standards based on established call center metrics including turn-around times

Keywords: Centene Coproration, Des Moines , Customer Service Representative II, Sales , Des Moines, Iowa

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