2nd Shift Customer Service Representative - Full-time / Part-time

Job Description:

This position is a front line service position providing assistance to members and providers regarding programs, policies, and procedures. Medicare Experience Preferred. Responsibilities include:

• 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.

• Assist in the mentoring and training of new staff.

• Assume full responsibility for self-development and career progression; proactively seek and participate in ongoing training's (formal and informal).

• 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 Magellan 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.

• Lead or participate in activities as requested that help improve Care Center performance, excellence and culture.

Working hours: Monday -Friday 11:00AM-9:30PM

Skills:

Requirements/Certifications:-Must be flexible in scheduling and comfortable with change - 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 good 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.