Primary City/State:

Tucson, Arizona

Department Name:

Customer Care

Work Shift:

Day

Job Category:

Administrative Services

As a Service Center Representative, you will be part of a fast-paced inbound customer service environment. Having call Center/Contact Center experience is a must, preferably in managed care. Healthcare Insurance experience with plans and benefits will be helpful in this role. The hours for this position are Monday - Friday 8:30AM-5PM MST. There may be occasional weekend trainings. Most major holidays off.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position supports the organization’s service center by providing daily customer service to physicians and/or staff, employees, health and dental plan members and dependents, payors, hospital staff, and the community at large. Herein referred to as “customer”.

CORE FUNCTIONS
1. Receives, documents, researches and responds to customer inquiries following established policies, procedures and standards. (Answer, identify, research, document, and respond to a diverse and high volume of inbound and outbound health insurance related customer calls on a daily basis.)

2. Prepares and/or initiates a variety of correspondence/documents in response to customer inquiries, following departmental procedures and compliance guidelines. (Meet quality, quantity, and timeliness standards to achieve individual department performance goals as defined within the department guidelines and compliance standards.)

3. Facilitates timely research and issue resolution through interaction and communication with the appropriate parties, which includes but is not limited to, department team members, employees within the organization, physician offices, and/or contracted plan representatives.

4. Works cohesively with team members to ensure delivery of outstanding customer service, in a positive work environment, that supports the department’s ongoing goals and objectives.

5. Fulfills informational needs of clients for care coordination of members, appropriate access to contracted providers, services of contracted managed care organizations, employee benefits, health and dental plan inquiries, and services of staff such as utilization review, prior authorization, billing and contract management.

6. Services inbound and outbound customer and staff communications for all facilities in the states in which they operate. Works with various departments and staff to provide accurate managed care information.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Demonstrated ability to provide essential customer service and knowledge in a high paced contact center environment as typically demonstrated with up to one year of experience, preferably in a healthcare or managed care. Ability to use technology tools to research and obtain accurate information to respond to customer inquiries via incoming calls, emails and/or instant messaging/chat avenues while maintaining a professional and service oriented demeanor at all times. Demonstrated ability to utilize computer and typing skills.

The candidate must possess excellent communication skills to maintain a positive and helpful attitude with customers. Must have the ability to follow oral and written directions as they relate to the functions listed above. Must have the ability to acquire and utilize a sound knowledge of the company’s customer information systems, as well as, fundamental knowledge of the organization’s benefit programs, as described above. Must possess excellent organizational and time management skills to display the ability to provide timely, accurate information on a variety of benefit-oriented subjects.

PREFERRED QUALIFICATIONS

Bilingual preferred. Associate's degree with at least one to two years experience in a high call volume service center strongly preferred.

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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