Company

Centene Corporation

Description

You could be the one who changes everything for our 28 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 times

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.

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.

Identifier

1c0d21ce3f2df6d357913362f62465f0