Senior Customer Service Representative - (San Antonio, TX)

Description: Position Purpose\: Resolve customer inquiries via telephone and written communicationin a timely and appropriate manner.Using current reference materials, answer inquiries from members and/or providers regarding claims, eligibility, covered benefits, authorizations and pharmacy related mattersProvide assistance to members and/or providers regarding web siteregistration and navigation Educate members and/or providers on health plan initiatives during telephone conversationsProvide 1st call resolution; working with appropriate internal/external resources, completing necessary follow-up, and ensuring closure of the inquiryDocument all activities for quality and metrics reporting through the Customer Relationship Management (CRM) applicationIdentify trends related to member and/or provider inquiries to respond proactively and provide feedback to managementProcess and follow through on all matters related to Provider Addition, Change and Termination (PACT) forms, Customer Service Forms (CSFs)