Responds to provider questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Proficient in all basic customer service areas performs some but not all types of moderately complex function. Must be able to successfully perform all the duties of the Customer Care Rep I. Primary duties may include, but are not limited to: Analyzes problems and provides information/solutions. Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information. Proficient in all basic customer service functions. Receives and places follow-up telephone calls / e-mails to answer customer questions. Inquiries may also be on a walk-in basis. May require deviation from standard practices and procedures with the assistance of a computerized system. Requires general knowledge of company services, products, insurance benefits, provider contracts and claims. Seeks, understands and responds to the needs and expectations of internal and external customers. Required to meet department goals and expectations.
Hours will be between 8:00AM to 4:30 PM EST. Monday through Friday.
Requires a HS diploma or GED: 1 to 3 years of WellPoint/CareMore experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background. Experience working with providers preferred. Experience working in a virtual environment preferred. Must be willing to travel (approx 5-10%) for training. Must be willing to work overtime (as needed/based on business need). Experience working with FACETS and EZCAP preferred. Claims experience required. Experience working with Medicare Programs required.