Medical Call Center CSR

Position Summary

Job Summary:

Under the direct supervision of the Customer Support Center Manager, the Customer Support Representative I (CSR) is the front line support to members, member advocates and providers. The CSR I provides superior customer service to all incoming callers while assisting with their inquiries and requests. Calls include but are not limited to eligibility verification, authorizations status, PCP changes, appeals and grievances. CSRs are expected resolve and/or escalate inquiries/requests and document each call interaction in a clear, concise, professional and timely manner.

Pay Rate: $23.00/hr

Responsibilities:
Provide superior customer service to all incoming callers to ensure an exceptional customer experience.

Receive and respond to incoming calls from members, member advocates, providers, health plan representatives, etc. Identify and resolve issues related to patient care and services.

Provide assistance with inquiries such as eligibility, authorizations status, PCP changes, appeals and grievance intake, and various other inquiries.

Make outbound calls for follow up purposes when needed. Set reasonable follow up expectations with callers and meet or exceed those commitments.

Continuously work on open inquiry log and maintain minimal open cases.

Adhere to individual and departmental key performance indicators (KPIs) such as number of inbound calls per day, wrap up time, handle time, QA audit performance,

Perform other duties as assigned.