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Customer Care Representative I – Telecommuter
Sharp HealthCareCustomer Care Representative responsible for member communication and problem-solving for health plan inquiries. Requires 6 months of customer service experience and a high school diploma.
About the role
Key responsibilities & impact- Responsible for direct and timely communication between the Plan and Plan members, potential members, providers, employer groups, brokers, internal departments and external agencies.
- Maintains high level of knowledge regarding Plan products, premiums, benefits and procedures.
- Uses knowledge and judgment to select appropriate resources for assisting callers.
- Provides information on all aspects of Plan products, premiums, benefits, policies and procedures.
- Responsible for accurate problem-solving. Researches and resolves concerns.
- Documents all calls in the IDX Customer Service Module immediately.
- Verifies prescription drug eligibility, benefits, claims, and authorizations in PBM's MedAccess system.
- Adds and updates member information in the MedAccess system.
- Verifies enrollment, benefits premiums and other individual and group information in Salesforce.
Requirements
What you’ll need- H.S. Diploma or Equivalent
- Less Than 1 Year Minimum of six (6) months experience as a Customer Call Center Representative.
- Associate's Degree in Business administration or health care administration preferred.
- 2 Years Customer service or medical office experience preferred.
- 1 Year Experience working full time as SHP Customer Care Temporary CCR I.
- Medical office certification, preferred.
- Ability to understand and resolve common Commercial member inquiries/complaints by phone.
Benefits
Comp & perks- Health insurance
- Paid time off
- Professional development opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
customer serviceproblem-solvingcall documentationprescription drug eligibility verificationclaims processingenrollment verificationbenefits verificationMedAccess systemSalesforce
Soft Skills
communicationjudgmentresearchresolutioninterpersonal skills
Certifications
H.S. Diploma or EquivalentAssociate's Degree in Business administrationAssociate's Degree in health care administrationMedical office certification