Customer Care Representative I Houston (Bi Lingual Spanish)

Customer Care Representative I Houston (BI LINGUAL SPANISH)Job ID: 2011 17156 # Positions: 1Location: US TX Houston Search Category: Customer ServiceType: Regular Full Time (30+ hours) Posted Date: 12/06/2011More information about this job:Summary:The West Regional Service Center (WRSC), with operations in Houston, TX, delivers member and provider services, claim operations, clinical precertification services, and a variety of support resources to customers in the Amerigroup West Region.Associates are focused on understanding and meeting the needs of our customers by connecting with the mission and vision in their daily work activity. While working with our customers over the phone, Customer Care associates use their analytical skills to identify issues and proactively engage to solve problems during the call. While anticipating the needs of our customers, Customer Care associates demonstrate good listening skills, strong verbal and written communication skills to help influence our customers resulting in an amazing customer experience.If you are looking for a way to make a difference in the lives of others by offering a little help to those in need, you are invited to further explore employment opportunities at Amerigroup.Responsible for responding to either inbound inquiries or outreach calls from/to potential and existing Amerigroup members and providers. Responsibilities include providing accurate information/education/resolution about eligibility status, benefit coverage, provider network, credentialing status, authorization/referral status, demographic changes and all other non claim issues.Responsibilities:1. Function as an information source through telephonic assistance to members, providers, billing agencies, and various company/department staff.2. Provide pleasant customer experience through superior customer service methods, problem solving and real time issue resolution.3. Interact with provider community and various departments to resolve issues involving the membership and credentialing status.4. Explain benefits, eligibility status, enrollment processing procedures and status of authorizations and referrals to callers.5. Assist with activities to ensure memberships continuity of care.6. Conduct member outreach calls as assigned to proactively educate members on services available (Welcome Calls), complete health assessments for plan case management (Early Case Findings and Healthy Beginnings) and conduct membership surveys.7. Process complaints, following established guidelines.8. Maintain knowledge of state guidelines, regulations, and departmental policies and practices and maintain accurate documentation for compliance.9. Performs other duties as assigned.Qualifications:EducationRequired: High School Diploma or GEDPreferred: Some completed college courses or degree.Years and Type of Experience Required: Required: Required: Required:Required: Two years of experience in customer service or call center environmentPreferred: Managed care experienceLanguage SkillsRequired: Bi Lingual SpanishPreferred: Other languages as determined by business need.Technical Competencies:Computer Hardware, Software, and Applications/ Office Equipment Basic Ability to use software and hardware of a computer to complete certain simple tasks. Ability to use standard office equipment such as telephone, fax machine and copy machine. Working knowledge in a windows environment to include navigation skills using a mouse and keyboard and use of the Internet. Ability to review and draft correspondence in email system and word processing systems. Ability to use spreadsheets to review, organize and edit data.Communication Skills: Verbal, Written and Call Handling Basic Ability to use proper language, grammar and style in the preparation of verbal and written messages to convey a clear, concise, friendly and appropriate message to business partners and customers