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Customer Care Professional II

Carolina Complete Health Durham, North Carolina

As part of the Customer Service department, you’ll use your knowledge of Centene’s insurance products and service to help our members understand their benefits, details and policy procedures. With your skills, you can help transform the health of every community, one person at a time.

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What does it take?

What are the qualities that will help you achieve success in this role at Centene?

Success Profile

  • Detail-oriented
  • Organized
  • Proactive
  • Positive
  • Trustworthy
  • Consistent

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Our Customer Service Roles

Customer Care Opportunities at Centene

Our Customer Service teams work to ensure high levels of service and customer satisfaction. Learn more about this vital group at Centene

Claims Analyst

As part of a tight-knit team and working as a partner to each provider, you’ll evaluate the needs of your health plan and process all claims in accordance with guidelines.

Claims Liaisons

While ensuring that provider and member requests are taken care of, you’ll review requests from providers and work with state health plans to ensure the accuracy and quality of claims.

Customer Service Representative

You’ll use your healthcare knowledge, analytical skills and our information resources to quickly and correctly answer questions from members and providers.

Enrollment Analyst

You’ll process incoming membership files and focus on maintaining the enrollment integrity of our individual health plan systems.

Systems Solutions Manager

While leading a team of business analysts, you’ll work with the IT department to drive end-to-end solutions for core applications supporting Centene’s operations. Claims Analyst.

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Responsibilities

Job ID 1164392

Category Customer Service
Schedule Full-time
Description:
Position Purpose: Act as the first point of customer contact for incoming or outbound healthcare contact center calls. Gather and verify demographic information, utilize tools and critical thinking, and route calls as appropriate following standard operating procedures. Resolve basic and complex verbal member issues in real time.

  • Answer incoming or make outbound healthcare contact center calls
  • Gather and verify demographic information and document calls using standard computer software and systems
  • Use tools and apply problem-solving skills to identify immediate caller needs, including potential crisis calls, and route calls to appropriate resource according to standard operating procedures
  • Document all call information according to approved operating procedures.
  • Use verbal communication strategies to effectively elicit information, gain confidence from caller and provide reassurance
  • Accurately identify caller’s presenting concerns and document per protocol
  • Identify and employ alternative approaches to communicate with callers when encountering barriers and escalate as needed
  • Meet quality assurance requirements and other key performance metrics, including punctuality and attendance
  • Assist with training and precepting of new hires
  • Participate in at least one quality, process improvement or employee engagement workgroup
  • Qualifications:

    Education/Experience: High school diploma or equivalent. 4+ years of customer service experience, preferably in a healthcare call center environment. Experience with Microsoft office applications and data entry systems. Experience with data entry and call documentation. Strong verbal and written communication skills. Bilingual in Spanish preferred.

    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.
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    Quote

    “Centene has been instrumental in my professional development. I’m pushed in a way that challenges my fears, improve my skills, and enhance my knowledge on healthcare.”

    - Meaghan Hooks, Business Analyst II

    “My job has a direct impact on our providers and members. With every claim paid out the door we are directly helping to save someone’s life!”

    - Jonelle Levy, Business Analyst II

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    Our Awards

    Centene is consistently recognized for how well we treat our members, our people, and the communities we serve.

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    Our Hiring Process

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    “Centene is an exciting company to work for.”

    Esmeralda Baig

    Started as a Case Manager, now a Senior Vice President of Operation

    See Esmeralda's career path

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