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Corporate Functions & Operations WellCare - Customer Service Careers

Customer Service Representative Job

Full Job Title: Customer Service Representative

Job Number: 1806432

Location: Phoenix, AZ

Date Posted: 2018-09-14

Responds to member and provider inquiries (phone, written or walk in) regarding all aspects of WellCare business, including claims, in a professional, timely, accurate and caring manner while consistently meeting all guidelines.

Location: Phoenix, AZ

Department: Ops-Compliant Resolution

Reporting to: Mgr, Operations

Essential Functions:
  • Responds to member, provider and other inquiries via telephone, correspondence or lobby walk-in while meeting all corporate guidelines and performance standards.
  • Demonstrates appropriate customer-care skills such as empathy, active listening, courtesy, politeness, helpfulness and other skills as identified.
  • Records, investigates and resolves member complaints as detailed in the Grievance Procedure narrative.
  • Assists in the education of new members and in the re-education of existing members regarding health plan procedures.
  • Logs, tracks and appropriately documents all issues utilizing on-line systems and procedures, and in accordance with all applicable guidelines and requirements.
  • Makes decisions that are consistent with the concept of a win-win-win for members, associates and WellCare.
  • Demonstrates based behaviors such as initiative, accountability and value.
  • Performs skills necessary to create a high-quality customer experience, as reflected through acceptable C-Sat scores, quality monitors and member feedback.

Education: High School Diploma
Experience: 6 months to 1 year practical work experience
Previous experience in a call center or customer service environment (preferred)
Licenses/Certifications: Customer service, quality or training certifications (preferred)
Special Skills (e.g. 2nd language):
Strong written and verbal communication skills and an ability to work with people from diverse backgrounds
Ability to multi-task, good organizational and time management skills
Ability to act on feedback provided by showing ownership of his or her own development
Ability to read, analyze, and interpret verbal and written instructions
Ability to write business correspondence
Ability to effectively present information and respond to questions from members
Ability to define problems, collect data, establish facts and draw valid conclusions
Seeks to build trust, respect and credibility with all partners through full, honest, consistent, and coordinated communication
Technical Skills/Requirements:
Knowledge of email systems such as Microsoft Outlook sufficient to communicate with both internal and external contacts
Knowledge of Word and/or Excel sufficient to enter data

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Last Updated On: 12/9/2015