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Customer Care Associate

Company: Suna Solutions Inc
Location: San Diego
Posted on: November 22, 2021

Job Description:

Overview: Our client, a US Fortune 500 company and a provider of managed Health care, Pharmacy benefits & specialty areas for managed care organizations / employers / government agencies, seeks an accomplished Customer Care Associate.*** Candidate must be authorized to work in USA without requiring sponsorship ****************************************************************************************************************************** Location: San Diego, CA 92108*** Duration: 12 months w/ possibility of extensionNotes: - Standard Hours: 8:00am - 4:30pm or 8:30am - 5:00pm (candidates must be available for both shifts). - Position will be remote during COVID closure but will return to office once offices are back open. - Sharp learning curve, 21 days of training.Description: - This is an entry level customer service role. - Candidate will receive inbound calls from members - include co payment or deductibles questions, appeals, grievances, etc. - Support team members and participate in team activities to help build a high-performance team. - Thoroughly documents customers' comments/information and forwards required information to the appropriate staff. - Actively listens and probes callers in a professionally and timely manner to determine purpose of the calls. - Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality. - Resolves customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction. - Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies. - Assumes full responsibility for self-development and career progression; proactively seek and participate in ongoing training sessions (formal and informal). - Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs. - Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help achieve business and operational goals. - Educates providers on how to submit claims and when/where to submit a treatment plan. Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved. - Informs providers and members on appeal process. Leads or participates in activities as requested that help improve Care Center performance, excellence and culture. - Links or makes routine referrals and triage decisions not requiring clinical judgment. Performs necessary follow-up tasks to ensure member or provider needs are completely met. - Provides information regarding in-network and out-of-network reimbursement rates and states multiple networks to providers. - Refers callers requesting provider information to Provider Services regarding professional provider selection criteria and application process. - Refers patients/EAP clients to the Care Management team for a provider, EAP affiliate, or Facility. - Responsible for updating self on ever changing information to ensure accuracy when dealing with members and providers. - Support team members and participate in team activities to help build a high-performance team. - Thoroughly documents customers' comments/information and forwards required information to the appropriate staff.Qualifications: - High School Diploma or GED required. - 1+ years of experience. - Customer Service experience. - Call center experience. - Writing and communication skills. - Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment. - Responsible for meeting call handling requirements and daily telephone standards as set forth by management. - Must agree to observing service for the purpose of training and quality control. - Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills. - Must be able to maneuver through various computer platforms while verifying information on all calls. - Must be able to talk and type simultaneously.Nice to haves: - Mental health knowledge. - Behavioral health knowledge. - Healthcare experience/knowledge.************************************************************************************************************************I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.Satwinder "Sat" SinghLead Technical RecruiterCompany Overview: Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients' businesses forward.Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.Contract length: 12 monthsJob Types: Full-time, ContractSchedule:

  • Monday to FridayAbility to commute/relocate:
    • San Diego, CA 92108: Reliably commute or planning to relocate before starting work (Required)Education:
      • High school or equivalent (Required)Experience:
        • Customer Service: 1 year (Required)
        • Call Center: 1 year (Required)
        • Healthcare / Medical: 1 year (Preferred)Work Remotely:
          • Temporarily due to COVID-19

Keywords: Suna Solutions Inc, San Diego , Customer Care Associate, Other , San Diego, California

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