Senior Customer Service Representative at Centene Corporation (San Antonio, TX)

| San Antonio, TX
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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 matter

  • Provide assistance to members and/or providers regarding website registration and navigation

  • Educate members and/or providers on health plan initiatives during telephone conversation

  • 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 processe

  • Process forms required to release pending claims to provider

  • Work with other departments on cross functional tasks and project

  • Maintain performance and quality standards based on established call center metrics including turn-around time

    Qualifications:

    Education/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.

    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.
    More Information on Centene Corporation
    Centene Corporation operates in the Healthtech industry. The company is located in Saint Louis, MO, Smyrna, GA, Columbus, GA and Sunrise, FL. Centene Corporation was founded in 1984. It has 19000 total employees. It offers perks and benefits such as Flexible Spending Account (FSA), Disability Insurance, Dental Benefits, Vision Benefits, Health Insurance Benefits and Life Insurance. To see all 374 open jobs at Centene Corporation, click here.
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