Customer Service Representative II (HNGSS)
Company: Centene Corporation
Location: Rancho Cordova
Posted on: May 31, 2021
- This is the advanced level of Customer Service Representative,
responsible for handling customer service questions and
- Associates at this level handle escalated issues that require
greater product and service knowledge, and a higher level of
customer service skill.
- The Customer Service Representative takes calls and processes
transactions, such as referrals, authorizations, etc.
- The Customer Service Representative also resolves urgent and
high profile problems from Beneficiary Counseling and Assistance
- Researches and responds to inquiries from beneficiaries and
providers, such as benefits, claims, eligibility concerns,
- Handles escalated and high priority customer service
- Resolves/de-escalates and/or escalates issues. Follows through
with each issue to resolution by working with internal and external
resources as needed.
- Receives calls for referrals and authorizations transactions,
reviews documents, and modifies authorizations/referrals as
prescribed by written procedures. Documents transactions in
appropriate medical management systems.
- Receives urgent/important/high profile calls from Beneficiary
Counseling and Assistance Coordinators (BCAC). Works with all
available resources to resolve issues quickly and within customers'
expectations, confirms solutions with BCAC, tracks calls and
solutions, and balances business decisions with customer
- Processes additional assignments, such as PCM changes, address
changes, ID card replacements, RAOC status calls and data entry,
and updates provider demographics/files, etc.
- Writes responses to inquiries.
- Collects and tracks data regarding escalations so trends and
issues can be identified or analyzed.
- Assists in training other Customer Service
- Demonstrates regular, reliable and predictable attendance.
- Other duties as assigned.
Education/Experience: High School diploma or GED.
Minimum two years high-volume customer service experience in a
demanding environment, preferably in a healthcare related industry;
1 year or more as a CSR I.
Bilingual preferred in Spanish.
As a government contractor, this position requires U. S.
citizenship and proof of favorable adjudication following
submission of Department of Defense form SF86 or higher
Upon submission of application, you will receive an additional
email from Centene with required assessments. Completion of the
online assessments is Mandatory and they must be completed in order
to progress to the next step in the hiring process
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Centene Corporation, Rancho Cordova , Customer Service Representative II (HNGSS), Other , Rancho Cordova, California
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