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Senior Customer Service Representative

Coordinated Care Tacoma, Washington

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 1149687

Category Customer Service
Schedule Full-time
Description:
Position Purpose: Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner.

Using current reference materials, answer inquiries from members and/or providers regarding claims, eligibility, covered benefits, authorizations and pharmacy related matters
Provide assistance to members and/or providers regarding website registration and navigation
Educate members and/or providers on health plan initiatives during telephone conversations
Provide first call resolution; working with appropriate internal/external resources, completing necessary follow-up, and ensuring closure of the inquiry
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Identify trends related to member and/or provider inquiries to respond proactively and provide feedback to management
Process and follow through on all matters related to Provider Addition, Change and Termination (PACT) forms, Customer Service Forms (CSFs), and claims projects in a timely manner. Conduct appropriate auditing processes
Process forms required to release pending claims to providers
Work with other departments on cross functional tasks and projects
Maintain performance and quality standards based on established call center metrics including turn-around times
Qualifications:

Education/Experience: High school diploma or equivalent. 3+ years of combined call center and customer service experience preferably in a healthcare or insurance environment. 1+ years of managed care experience preferred. Associate’s degree and claims processing, billing and/or coding experience preferred. Depending on the state, bi-lingual skills may also be 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

Learn more about our hiring process and discover other helpful information for applicants.

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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

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