Customer Service Specialist
Interfaces with customers via telephone, written correspondence, fax, web, and/or electronic mail to respond to routine inquiries and resolve concerns. Explains members rights and responsibilities in accordance with contract. Educates providers on self-service options. Researches customer information by effectively using appropriate database in response to inquiries including, but not limited to, authorizations, payments, denials, coordination of benefits, and eligibility. Investigates, analyzes, and resolves outstanding issues to achieve customer satisfaction; takes responsibility for following through and bringing outstanding issues to closure. Maintains complete and accurate documentation of all customer interactions. Performs other duties as required