About Us
Founded as a single health plan in 1984, Centene Corporation has established itself as a leader in the healthcare services field. Our core philosophy is that quality healthcare is best delivered locally. By recognizing the cultural and ethnic sensitivities of the communities we serve, we are better prepared to act in the best interest of our core constituency - Medicaid recipients. In addition, we provide specialty services including behavioral health, disease management, managed vision, nurse triage, pharmacy benefit management and treatment compliance to our own and other healthcare organizations.
As we continue to grow, we use the phrase Reaching for the Summit™ to describe our dual goal of striving for excellence in offering quality healthcare to our members while building a leading multi-line managed care enterprise. More importantly, it also describes the dedication and passion that compels and drives our employees.
Bilingual Customer Relations Representative l
Centene Corporation is a leading multi-line healthcare enterprise that provides managed-care programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children’s Health Insurance Program (SCHIP).
Position Purpose:
Responsible for telephone inquires in both English and Spanish from providers, members, and contracted health plan personnel to address eligibility/benefit information, claim inquiries, instruct providers/ members on appropriate procedures and initiate corrective action when necessary.
Knowledge/Experience:
Requires a High School Diploma or GED with 6 months of professional customer service experience preferably in the healthcare field. Fluent in Spanish.
Competencies:
Team Member: Integrity, Flexibility, Communication, Critical Thinking, Quality Orientation, Building Customer Loyalty, Building Strategic Working Relationships, Contributing to Team Success
Position Responsibilities:
•Explain health plan vision benefits to members and address concerns regarding payment or denial of claims.
•Assist members with locating local providers.
•Respond to questions and concerns from members and providers regarding eligibility/benefit information, claim inquiries and instruct providers in proper procedures for filing claims.
•Identify and initiate correct procedure for incorrect claim payments.
Communication Skills,Microsoft Excel,Microsoft Word
