Customer Care Specialist - Medicare
13.00 an hr
Typical Hours: Monday through Friday 8 AM to 5:00 PM
Looking for a detail-oriented individual to join our Quality Assurance Team that performs quality audits on work that is performed by internal departments such as Provider Relations, Call Center, Claims and Program Support in order to meet the contractual obligations to the State client.
- Team and Goal Oriented
- Proficient Communication
- Customer/Client Focus
- Organizational Skills
- Problem Solving/Analysis
Duties and Responsibilities include:
- Listening to recorded calls and evaluating for accuracy based on set expectations.
- Ensure claims information is entered accurately into MMIS system.
- Reviewing all Enrollment Broker, Provider Relations entries for accuracy.
- Ensures productivity meets or exceeds services and quality standards
- Verify File Update Requests (Furs) are entered into the system correctly and responded to within contract requirements.
- Verify the timeliness of processing claims through document control.
- Covering for front desk admin as needed.
- Other duties as assigned
- Quality Assurance experience preferred
- Medicaid or Health Insurance experience preferred
- Ability to work well with people under occasional stressful and demanding conditions; develop and maintain effective working relationships with a variety of individuals; identify when to ask for help and be willing to ask for help when appropriate.
- Must be a self-starter that is unselfishly motivated and able to demonstrate the initiative to meet business/department needs.
- Must be able to show commitment to consistently doing high quality work and occasionally going above and beyond.
- Able to embrace coaching and feedback from peers and management.
- Must have the ability to operate general office equipment, Microsoft Office products as well as specialized software.
- Follow procedures expected of all staff and act in a professional manner.
- Typical Hours: Monday through Friday 8 AM to 5:00 PM
- Some overtime may be required.
MMC, is an Equal Opportunity Employer, M/F/D/V. Please feel free to contact us if you are an individual with a disability and require accommodation in the application process.