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Customer Care Associate in Phoenix, AZ at Pride Health

Date Posted: 11/9/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Phoenix, AZ
  • Experience:
    Not Specified
  • Date Posted:
    11/9/2018

Job Description

Currently seeking a Customer Care Associate in Phoenix AZ! This position is a front line service position providing assistance  members and providers regarding programs, policies, and procedures.

Duties:

  • Answers incoming calls related to eligibility, benefits, claims and authorization of services from members or providers.
  • Manages administration of intake documentation into the appropriate systems.
  • Provides outstanding service to internal and external customers and strive to resolve member and provider needs on the first call.
  • 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.
  • Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
  • 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.
  • Thoroughly documents customers comments/information and forwards required information to the appropriate staff.

Skills:

  • Must be flexible in scheduling and comfortable with change as 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 strong 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.