Job Responsibilities : Customer Service Rep CCBH- Pittsburgh
Salary : $14 per hour
Company : UPMC
Location : Remote US
Educational requirements : High School
- Maintains comprehensive understanding of member benefits covered benefits limitations exclusions policies and procedures computer screens and code definitions and maintains current awareness of plan changes and developments.
- Remain current on all departmental policies; procedures plan benefit designs and modifications.
- Coordinates members’ use of the complaint process and assists Members as needed at all levels of the complaint process according to policy.
- Provides information regarding Community Care operations and answers any questions.
- Responds to member inquiries and describes member rights and responsibilities.
- Document inquiries in accordance with Community Care Customer Service guidelines.
- May engage in the acquisition or transfer of structured clinical data but does not engage in any activities that involve clinical evaluation or interpretation.
- Collects information from members concerning problems with accessing services and/or benefits and uses that information to recommend modifications to plan policies and procedures to improve the service to members.
- Provides members with updated information changes to the network benefit plan or procedures.
- Makes outreach calls under supervision of care management staff.
- Contacts assigned members for various outreach and follow up initiatives.
- High school diploma or equivalent required some college preferred.
- Proficient in typing required.
- Basic analytical skills necessary to evaluate caller inquiries.
- Strong interpersonal and verbal skills required.
- Ability to work independently required.
- Demonstrates good organizational skills.
- Minimum of 6 months of customer service and/or call center experience behavioral health call center a plus.
- General knowledge of computers required.
- Microsoft windows environment.