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in North Highlands, CA

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About this job

Position Purpose: The Customer Service Representative (CSR) functions as a primary resource in handling TRICARE customer contacts via telephone, ranging from routine to complex. The CSR provides clear and concise education concerning the TRICARE medical benefits and government policies and procedures. The CSR assists beneficiaries with benefit information, referral and authorization requirements, claims, provider locations and all other routine TRICARE issues. The CSR forwards escalated or crisis calls to appropriate staff members.

  • Answers phones and researches inquiries concerning benefits, enrollment, etc.
  • Researches and documents/updates databases such as net to net changes, CCM documentation, etc.
  • Provides information to internal and external customers.
  • Regenerates copies of pertinent correspondence.
  • Processes additional assignments, such as PCM changes, address changes, ID card replacements, RAOC status calls and data entry, etc.
  • Demonstrates regular, reliable and predictable attendance.
  • Other duties as assigned.

  • Education/Experience: High School Diploma or GED.
    Six months call center, customer service, insurance or medical experience preferred.
    This position will be supporting a Federal government contract, therefore it requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 or higher security.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.