You could be the one who changes everything for our 26 million members as a Customer Care professional at Centene. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner.Using current reference materials, answer inquiries from members and/or providers regarding claims, eligibility, covered benefits, authorizations and pharmacy related matters
Provide assistance to members and/or providers regarding website registration and navigation
Educate members and/or providers on health plan initiatives during telephone conversations
Provide first call resolution; working with appropriate internal/external resources, completing necessary follow-up, and ensuring closure of the inquiry
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Identify trends related to member and/or provider inquiries to respond proactively and provide feedback to management
Process and follow through on all matters related to Provider Addition, Change and Termination (PACT) forms, Customer Service Forms (CSFs), and claims projects in a timely manner. Conduct appropriate auditing processes
Process forms required to release pending claims to providers
Work with other departments on cross functional tasks and projects
Maintain performance and quality standards based on established call center metrics including turn-around timesEducation/Experience: High school diploma or equivalent. Associates’ degree preferred or equivalent education and/or experience preferred One-year experience as a Customer Service Representative or previous Call Center, Healthcare or insurance experience. Should be proficient in understanding the working of a call center environment. Expert in customer service, verbal communication over the phone. Six months claims processing, billing and/or coding experience preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.
Position Type: Regular Your Opportunity Schwab was built around a simple idea: put the client first. Lots of companies say...Apply For This Job
CALLING ALL COMMERCIAL INSURANCE PROFESSIONALS I’ve partnered with a large insurance company who is looking for a Commercial Insurance Account...Apply For This Job
Why Join Recro: Mission and Culture: Our leadership proactively works to create and foster a culture that exemplifies our core...Apply For This Job
3.8 11 hours ago Full Job Description About our group:The Global Talent Management team is building a world-class talent strategy...Apply For This Job
Full-time 16 hours ago Full Job Description Essential Job Functions Verify components are on the production line/delivery location Verify finished...Apply For This Job
Please note that the home location for this role can either be Gainesville, GA or Houston, TX. Must be willing...Apply For This Job