: Customer Service Representative

Customer Service Representative

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.

Job Description

To increase satisfaction, retention, and growth by efficiently delivering competitive services to members or providers through a fully-integrated organization staffed by knowledgeable, customer-focused professionals supported by exemplary technologies and processes.

Handle customer service inquiries and problems via telephone, internet and, or written correspondence in a professional courteous manner. Quickly read and reinterpret information to caller(s) in a manner that meets their level of comprehension with or without scripts.

Qualifications

Experience in a production environment or a transaction based environment such as a call center or like setting in behavioral or medical healthcare is preferred.

Customer Service experiences is required.

Additional Information

Answers questions and resolves issues based on phone calls/letters from members, providers, and internal customers.

Documents and tracks contacts with members, providers and internal customers appropriately.

Is vigilant in identifying possible compliance/ethics issues and reports any concerns to manager/supervisor, Medicaid Compliance Officer, internal legal counsel or Alert Line.

Handles customer service inquiries and problems via telephone, internet or written correspondence.

Customer inquiries are related to but not limited to health care claims, eligibility, authorizations, appeals and disputes, contracting, web portal inquiries, etc.