Anthem, Inc Customer Care Representative Sr - Union - Rancho Cordova, CA - PS18932 in Rancho Cordova, California

Customer Care Representative Sr - Union - Rancho Cordova, CA - PS18932

Location: Rancho Cordova, California, United States

Field: Union

Requisition #: PS18932

Post Date: Mar 14, 2019

Customer Care Representative Sr - Union - Rancho Cordova, CA - PS18932

Senior Customer Care Representative I U-20

The associate will resolve complex, difficult and/or non-routine submitted claims or customer services issues requiring special handling. May be assigned to take routine calls, CHAT queues and/or process claims as needed. Interprets policy and contract eligibility. Responsibilities include:

  • Ensures claims are settled satisfactorily and that favorable relationships are maintained. Advises and/or guides assigned department personnel in applying policies and procedures

  • Conducts training of assigned department personnel

  • Performs quality review of work performed by assigned department personnel

  • Monitors department audit results to ensure quality goals are being met and monitors department workflow to ensure production plans are being met

  • Contacts customers (i.e. subscribers, providers, groups, brokers, and/or policy holders) during the course of review to clarify and/or gather additional information required to resolve inquires and/or process claims.

  • Assists in development of improved workflows and methods.

  • Prepares department reports.

  • Two (2) years’ experience as an Anthem Customer Service Representative and meeting expectations for quality, quantity and attendance.

  • This position will support CSRS assigned to telephones, CHAT queues, claims.

  • Thorough knowledge of all related claims functions (i.e. claims entry, claims processing, PAC, adjustments etc.)

  • Thorough knowledge of medical terminology.

  • Demonstrate excellent communication skills both in verbal and written forms, as well as personal computer and problem-solving skills and possess experience in successful resolution of high level/sensitive customer service issues.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. An Equal Opportunity Employer/Disability/Veteran