: Customer Service Representative at Integrated Resources

About The Role

To increase satisfaction, retention, and growth by efficiently delivering competitive services to members or providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.
Handle customer service inquiries and problems via telephone, internet and, or written correspondence in a professional courteous manner. Quickly read and reinterpret information to caller(s) in a manner that meets their level of comprehension with or without scripts.
Experience in a production environment or a transaction based environment such as a call center or like setting in behavioral or medical healthcare is preferred.
Customer Service experiences is required
Answers questions and resolves issues based on phone calls/letters from members, providers, and internal customers.
Documents and tracks contacts with members, providers and internal customers appropriately.
Is vigilant in identifying possible compliance/ethics issues and reports any concerns to manager/supervisor, Medicaid Compliance Officer, internal legal counsel or Alert Line.
Handles customer service inquiries and problems via telephone, internet or written correspondence.
Customer inquiries are related to but not limited to health care claims, eligibility, authorizations, appeals and disputes, contracting, web portal inquiries, etc.