Member Svc. Rep.

Job description

Job Summary: Responsible for receiving and handling incoming calls on the general 1-800 numbers and provide first call resolution for members and callers. Directs calls as necessary and/or takes detailed messages if unable to complete request of caller. Provides excellent customer service to all callers/customers and provides requested information as needed. Essential Functions: - Answer and handle phone calls and warm transfer only as needed. - Assist members with finding providers and setting up appointments. - Demonstrate knowledge of eligibility and benefits for all plans. - Provide information to callers about our Plans. - Write notes for all incoming calls in CaseTrakker - Document care management notes captured during member call and works closely with care management team to support member needs. - Completes grievance and incident reports. - Assist members with calling DME vendors, pharmacy, doctors and other providers as needed to coordinate services. - Perform any other job related duties as requested. Education and Experience: - High School or GED required - Associates or Bachelor's degree preferred - One (1) year Previous Call Center Experience preferred - Previous expe...