Managed Care Health Plan located in Brooklyn, NY is seeking several Bilingual Mandarin Customer Service Representatives for an immediate role.
Responds to member and provider inquires and requests concerning complaints, benefits and claims, eligibility, and authorization inquiries within a call center environment in order to ensure high quality customer service to members and providers.
Responsibilities:
• Receives calls from providers, billers, office staff, vendors, PCW agencies and provider advocates.
• Responds to provider inquiries and claim, eligibility, authorization, and appeal status.
• Records all calls and necessary details.
• Receives requests for claims adjustments.
• Processes Correspondence, Faxes and Callbacks.
• Competency in multiple computer systems.
• Document a variety of member-related issues, such as: hospital admissions/discharges, SNF admissions/discharges, and CHHA episodes. Refer issues to Utilization/Medical/Care Management as appropriate.
• Record all calls and detail.
Qualifications:
• Bachelors Degree
• Microsoft Office
• Excellent verbal, communication and active listening skills
• Ability to identify and resolve problems
• Ability to work independently
• Excellent time management and organizational skills
• Assess member/provider needs, identifies changes and refer appropriately
• Proficient in handling high volume of calls and type at least 40 wpm.
For more: http://www.talenthubworldwide.com/