Customer Care Representative II | HMO on Day 1 + 2 dependents | ILOILO
Carelon Global Solutions
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Responsible for responding to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Proficient in all basic customer service areas performs some but not all types of moderately complex function. Must be able to successfully perform all the duties of the Customer Care Rep II. Primary duties may include, but are not limited to:
- Analyzes problems and provides information/solutions. Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
- Thoroughly documents inquiry outcomes for accurate tracking and analysis.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
- Researches and analyzes data to address operational challenges and customer service issues.
- Provides external and internal customers with requested information. Proficient in all basic customer service functions.
- Receives and places follow-up telephone calls / e-mails to answer customer questions. Inquiries may also be on a walk-in basis.
- May require deviation from standard practices and procedures with the assistance of a computerized system.
- Seeks, understands and responds to the needs and expectations of internal and external customers.
- Required to meet department goals and expectations. Requires a HS diploma or equivalent;1-3 years of the company's experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background.
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