- Provides courteous and prompt service to all internal and external customers.
- Research provider questions regarding status of reviews/authorizations
- Prioritizes and addresses requests in a professional manner to develop cooperative relationships and to ensure that customer confidentiality is assured.
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- Understands when to escalate a call to a supervisor.
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- Enters all call data for tracking.
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- Initiates outbound calls as necessary to facilities and providers. In the rare instances, a callback will be made to member/beneficiaries.
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- Provides customer service telephone line coverage within contract parameters of wait time and abandonment rates.
- Identifies opportunities and recommends methods to improve service and work processes.
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- Performs other services as required.
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