: Customer Care Associate at Integrated Resources INC

About The Role

This position is a frontline service position providing assistance to client’s 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. Overall expectations is to provide outstanding service to internal and external customers and strive to resolve member and provider needs on the first call.
Bilingual only (Spanish)
Must be a proficient typist (avg. 35+ WPM)
Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls.
Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.