Call Center Rep, Sr
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Job Location:
Houston, MS - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
We are searching for a Senior Call Center Representative someone who works well in a fast-paced this position you will serve as a member and/or provider advocate that understands the organizations processes policies and procedures to investigate resolve and/or facilitate the resolution of simple to complex issues/questions. You will be the first point of contact for assistance or information regarding eligibility benefits authorizations claims referrals and/or any other member/provider demands. Lastly you will assist and advocate for members and/or providers throughout the complaint and appeal process and support members with timely appointment scheduling.
Think youve got what it takes
Job Duties & Responsibilities
Act as a secondary resource to Call Center Representatives in the absence of the Team Lead and responds to escalated calls and triages to management if necessary
Identify and handle a variety of routine to complex customer or prospect inquiries or requests
Educate members about their health coverage benefits and services and empowering members/providers by directing them toward available resources for self-help
Meet Senior Member Service Representative performance goals for customer satisfaction quality productivity and all performance metrics
Ensure all HIPAA and state privacy and confidentiality requirements/regulations are adhered to at all times
File complaints and appeals on behalf of members and providers within the regulatory timeframe and in compliance with departmental policies and procedures
Skills & Requirements
High school diploma or GED
Minimum of 3 years of customer service call center and/or experience within managed care or insurance industry or
A Bachelors degree may substitute for two (2) years of the required experience
Required Experience:
Senior IC
Key Skills
- Hp Unix
- Administration & Operation
- Ado
- IT Security
- Management Administration
About Company
Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades suc ... View more
