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Lead Customer Service Representative

Company: Centene Coproration
Location: Baton Rouge
Posted on: January 16, 2020

Job Description:

Description: Position Purpose: Serve as a liaison between Customer Service Representatives CSRs), management and other various departments. Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner. Investigate and resolve complex claims matters in coordination with health plan and/or corporate departments Coordinate the day-to-day work functions, acting as a go to person and investigating and resolving complex issues Initiate change requests to resolve system configuration questions impacting claims processing; review and test results Conduct appropriate auditing processes Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters Educate members and/or providers on health plan initiatives; train and assist providers regarding proper claims billing procedures Provide first call resolution and own the process by working with appropriate internal/external resources and ensure the closure of all inquiries 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 Collaborate with other departments on cross functional tasks and projects Maintain performance and quality standards based on established call center metrics including turn-around times

Keywords: Centene Coproration, Baton Rouge , Lead Customer Service Representative, Hospitality & Tourism , Baton Rouge, Louisiana

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