Sunshine State Health Plan Looking for Customer Service Representative I at Orlando, FL Full Time

Position Purpose:

Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner.

• Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources
• Provide assistance to members and/or providers regarding website registration and navigation
• 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 timely follow up
• May coordinate member transportation and make referrals to other departments as appropriate
• Maintain performance and quality standards based on established call center metrics including turn-around times
• Foundation Care:
• Ensure pharmacy orders and invoices are distributed appropriately to patients and physicians; input patient information into Customer Relationship Management application (CRM) and manage patient billing services
• Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment
• Identify any trends related to incoming or outgoing calls that may provide policy or process improvements to support excellent customer service, quality improvement and call reduction
  High school diploma or equivalent. Computer skills and ability to learn new systems. While previous customer service, call center, healthcare or insurance experience (and in some markets – bilingual skills) are preferred – they are not required. We will consider candidates who meet the education requirements and who share our passion for supporting the health and well-being of our communities.

  For Foundation Care Only: Ability to complete Missouri Registered Pharmacy Tech application on 1st day of hire to obtain non-restricted Missouri Registered Pharmacy Tech within 30 days of hire or Active Missouri Registered Pharmacy Tech license.

  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.