Customer Service Representative II (HNGSS
Location: Rancho Cordova
Posted on: December 5, 2019
Customer Service Representative II (HNGSS) USA-California-Rancho
Cordova, USA-Virginia-Hampton Position Purpose: This is the
advanced level of Customer Service Representative, responsible for
handling customer service questions and issues. Associates at this
level handle escalated issues that require greater product and
service knowledge, and a higher level of customer service skill.
The Customer Service Representative takes calls and processes
transactions, such as referrals, authorizations, etc. The Customer
Service Representative also resolves urgent and high profile
problems from Beneficiary Counseling and Assistance Coordinators.
Researches and responds to inquiries from beneficiaries and
providers, such as benefits, claims, eligibility concerns,
authorizations, etc. Handles escalated and high priority customer
service issues. Resolves/de-escalates and/or escalates issues.
Follows through with each issue to resolution by working with
internal and external resources as needed. Receives calls for
referrals and authorizations transactions, reviews documents, and
modifies authorizations/referrals as prescribed by written
procedures. Documents transactions in appropriate medical
management systems. Receives urgent/important/high profile calls
from Beneficiary Counseling and Assistance Coordinators (BCAC).
Works with all available resources to resolve issues quickly and
within customers expectations, confirms solutions with BCAC, tracks
calls and solutions, and balances business decisions with customer
needs. Processes additional assignments, such as PCM changes,
address changes, ID card replacements, RAOC status calls and data
entry, and updates provider demographics/files, etc. Writes
responses to inquiries. Collects and tracks data regarding
escalations so trends and issues can be identified or analyzed.
Assists in training other Customer Service Representatives.
Demonstrates regular, reliable and predictable attendance. Other
duties as assigned. Education/Experience: High School diploma or
GED. Minimum two years high-volume customer service experience in a
demanding environment, preferably in a healthcare related industry;
1 year or more as a CSR I. 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.
Keywords: Cenpatico, Sacramento , Customer Service Representative II (HNGSS, Sales , Rancho Cordova, California
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