Member Services Representative - (DS11573)

Centene Corporation provides multi-line managed care programs and related services to individuals receiving benefits in Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance (SCHIP). Centene operates health plans in seven states. In addition, the Centene contracts with other healthcare organizations to provide specialty services including behavioral health, disease management, nurse triage and treatment compliance.

Position Purpose:
Receive and respond to member/customer inquiries via telephone and written correspondence in a timely and professional manner.

Knowledge/Experience:
High school education or equivalent. At least 1 year customer service experience in a call center environment, preferably in a Medicaid managed care or insurance environment. Bilingual preferred.

Competencies:
Team Member: Integrity, Flexibility, Communication, Critical Thinking, Quality Orientation, Building Customer Loyalty, Building Strategic Working Relationships, Contributing to Team Success


Position Responsibilities:

o Receive and respond to all telephone or written correspondence inquiries from members within established timeframes and policies.

o Assist members with plan benefits via telephone, in writing, in person or make referral to outreach representative as appropriate.

o Document in the computer system all members' issues and resolution.

o Utilize current reference materials to assist and resolve any member inquiries.

o May coordinate member transportation.







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