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Our customer service teams have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.
Employees in this position include those responsible for initial Triage of members, Administrative Intake of members or managing the Admission/discharge information post-notification, and working with hospitals and the Clinical team. Function includes managing Incoming calls, managing requests for services from Providers/members, providing information on available Network services and transferring members as appropriate to Clinical staff. Also manages the Referrals process, processes Incoming and Outgoing Referrals, and Prior Authorizations. This function also includes Intake, Notification and Census roles.
- Respond to Incoming Provider and Enrollee calls.
- Resolve Customer Service inquiries
- Assist with faxes and emails.
- Moderate work experience within own function.
- Some work is completed without established procedures.
- Basic tasks are completed without review by others.
- Handle pre-authorization calls for upcoming surgeries, hospital admissions, imaging and therapy, etc.
- Supervision/guidance is required for higher-level tasks.
- Other duties as assigned by manager and/or director