SR Customer Service Rep II - Full-time / Part-time

Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner
* Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters
* Provide assistance to members and/or providers regarding website registration and navigation
* Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries
* Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
* Process written customer correspondence and provide the appropriate level of follow-up in a timely manner
* Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment
* Identify trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards
* Work with other departments on cross functional tasks and projects
* Maintain performance and quality standards based on established call center metrics including turn-around times

Contact

Ritz

Recruiter - Aston Carter - Aerotek

Contact number : 512 - 366- 7693 Ext. 57375

Aerotek is acting as an Employment Agency in relation to this vacancy.