Customer Service Associate

Title: Customer Service Associate

Duration: till December

Location: Orange, CA 92868

WORK SCHEDULES/SHIFTS: Shifts are subject to change based on business needs.

11:30am - 8pm

9:30am - 6pm

Description

·This position is a frontline service position providing assistance to members and providers regarding programs, policies, and procedures.

·Responsibilities include answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers.

·Responsibilities also include the administration of intake documentation into the appropriate systems.

·Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.

·Demonstrate flexibility in areas such as job duties and schedule in order to aid in better serving members and help achieve its business and operational goals. - Educates providers on how to submit claims and when/where to submit a treatment plan. - Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved.

· Informs providers and members on appeal process.

·Performs necessary follow-up tasks to ensure member or providers needs are completely met.

· Provides information regarding company’s in-network and out-of-network reimbursement rates and states multiple networks to providers.

·Refers callers requesting provider information to Provider Services regarding company’s professional provider selection criteria and application process.

Requirements/Certifications: Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment. Responsible for meeting call handling requirements and daily telephone standards as set forth by management. Must agree to observing service for the purpose of training and quality control. Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills. Must be able to maneuver through various computer platforms while verifying information on all calls. Must be able to talk and type simultaneously. Customer Service High School (Required) Associates Bachelors GED (Required)

KEY SKILLS:

- Must be comfortable working in a Call Center environment

- Must have Call Center experience, at least one year.

- Able to multi-task taking calls

- Strong communication skills