Customer Service Rep

Job Details

• Provides courteous and prompt service to all internal and external customers.
• Researches provider questions regarding status of reviews/authorizations.
• Prioritizes and addresses requests in a professional manner to develop cooperative relationships and to ensure that customer confidentiality is assured.
• Understands when to escalate a call to a supervisor.
• Enters all call data for tracking.
• Initiates outbound calls as necessary to facilities and providers.
• In the rare instances, a callback will be made to member/beneficiaries.
• Provides customer service telephone line coverage within contract parameters of wait time and abandonment rates.
• Identifies opportunities and recommends methods to improve service and work processes.
• Performs other services as required.