Customer Care Representative I – Telecommuter

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Logo of Sharp HealthCare

Sharp HealthCare

10,000+ employees

Founded 1946

🧘 Wellness

Healthcare • Nursing • Wellness

Sharp HealthCare is a healthcare organization dedicated to providing high-quality medical services to patients and families. With a commitment to innovation, safety, and excellence, Sharp HealthCare offers a range of career opportunities in nursing, clinical support, administration, and various medical specialties. The organization emphasizes a collaborative work environment and is recognized for its nursing excellence, aiming to advance the science of medicine alongside compassionate patient care.

📋 Description

• 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

• 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

• Health insurance • Paid time off • Professional development opportunities

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