Centene is hiring multiple Customer service positions in all 50 US state Nationwide
The salaries for these positions are above the national average. Based on Indeed Centene customer service representative salary is $24.00 per hour
At Centene, we welcome state-of-the-art innovation and sincere community relationships that help make everyone’s lives more healthy and informed. In addition to our status as the largest Medicaid Managed Care Organization in the country, Centene is also the largest carrier on the Health Insurance Marketplace and a lauded leader in managed long-term services and supports. Read employee reviews, salaries, and benefits here
Bonus Eligible$3,000 Sign-on Bonus -
*Applicants for this job have the flexibility to work from home and must reside in Hawaii. This job is eligible for a $3,000 sign-on bonus.*
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner.
Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources
Provide assistance to members and/or providers regarding website registration and navigation
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
The process was written customer correspondence and provided the appropriate level of timely follow-up
May coordinate member transportation and make referrals to other departments as appropriate
Maintain performance and quality standards based on established call center metrics including turn-around times
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Remote Nationwide, Bonus Eligible
Applicants for this job have the flexibility to work from home anywhere in the United States. This job is eligible for a $3,000 sign-on bonus.*
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner
Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters
Provide assistance to members and/or providers regarding website registration and navigation
Educate members and/or providers on health plan initiatives Provide first call resolution working with appropriate internal/external resources, and ensure closure of all inquiries
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Process was written customer correspondence and provide the appropriate level of follow-up in a timely manner
Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment
Identify trends related to member and/or provider inquiries that may lead to policy or process improvements that support excellent customer service and impact quality and performance standards
Work with other departments on cross-functional tasks and projects
Maintain performance and quality standards based on established call center metrics including turn-around time
Remote Nationwide, Bonus Eligible
Applicants for this job have the flexibility to work from home anywhere in the United States. This job is eligible for a $3,000 sign-on bonus.*
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Act as the first point of customer contact for incoming or outbound healthcare contact center calls. Gather and verify demographic information, utilize tools and critical thinking, and route calls as appropriate following standard operating procedures. Resolve basic and complex verbal member issues in real-time.
Answer incoming or make outbound healthcare contact center calls
Gather and verify demographic information using standard computer software and systems
Use tools and apply problem-solving skills to identify immediate caller needs, including potential crisis calls, and route calls to an appropriate resources according to standard operating procedures
Document all call information according to approved operating procedures
Use verbal communication strategies to effectively elicit information, gain confidence from caller and provide reassurance
Accurately identify caller’s presenting concerns and document per protocol
Identify and employ alternative approaches to communicate with callers when encountering barriers and escalate as needed
Meet quality assurance requirements and other key performance metrics, including punctuality and attendance
Education/Experience:
High school diploma or equivalent. 2+ years of customer service experience, preferably in a healthcare call center environment. Experience with Microsoft Office applications and data entry systems. Experience with data entry and call documentation. Strong verbal and written communication skills. Bilingual in Spanish preferred.
Remote Nationwide
Position Purpose:
Supervise the customer service workforce management function including forecasting, scheduling, call routing, service level management, and business continuity. Support multiple functional areas with long-range planning, short-term scheduling, and real-time service level management. Ensure consistency of processes, optimization of systems, and achievement of performance metrics
Supervise all activities related to the workforce management function
Monitor all call activities at various call centers and make necessary staffing adjustments
Monitor agent productivity, identify gaps, and provide feedback to management
Evaluate and allocate staffing based on analysis of schedules, call volume, etc.
Assist with gathering requirements and RFP responses for new business
Identify staffing needs and forecasting for new business
Ensure consistency and accuracy between telephone and workforce management systems through audits
Monitor call center performance, analyze results against company objectives and campaigns and provide feedback and recommendations to management
Assist with the development of policies and procedures for the workforce department
Understand and translate business requirements into detailed system requirements for call center routing
Work with team to determine most effective call routing delivery to best able to handle specific call types.
Remote in Arizona
Position Purpose:
Serve as a liaison between Customer Service Representatives CSRs), management, and other various departments. Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner.
Investigate and resolve complex claims matters in coordination with health plan and/or corporate departments
Coordinate the day-to-day work functions, acting as a “go-to” person and investigating and resolving complex issues
Initiate change requests to resolve system configuration questions impacting claims processing; review and test results
Conduct appropriate auditing processes
Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits, and authorization status matters
Educate members and/or providers on health plan initiatives; train and assist providers regarding proper claims billing procedures
Provide first call resolution and “own the process” by working with appropriate internal/external resources and ensure the closure of all inquiries
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Identify trends related to member and/or provider inquiries to respond proactively and provide feedback to management
Collaborate with other departments on cross-functional tasks and projects Maintain performance and quality standards based on established call center metrics including turn-around times
- Remote in Nevada
**Applicants for this job have the flexibility to work from home and must reside in Nevada. This job is eligible for a $3,000 sign-on bonus.**
Position Purpose:
Respond to customer inquiries via telephone and written correspondence in a timely and appropriate manner.
Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available resources
Provide assistance to members and/or providers regarding website registration and navigation
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Process was written customer correspondence and provide the appropriate level of timely follow-up
May coordinate member transportation and make referrals to other departments as appropriate
Maintain performance and quality standards based on established call center metrics including turn-around times
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
High school diploma or equivalent. Computer skills and ability to learn new systems. While previous customer service, call center, healthcare or insurance experience (and in some markets – bilingual skills) are preferred – they are not required. We will consider candidates who meet the education requirements and who share our passion for supporting the health and well-being of our communities.
*Applicants for this job have the flexibility to work from home anywhere in the United States. This job is eligible for a $3,000 sign-on bonus.*
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose:
Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients
Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required
Obtain verbal authorizations and request detailed clinical information from prescribers
Approve coverage determination requests based on defined criteria
Enter and document coverage determination request decision into the PBM system and notify providers and/or members
Respond to client inquiries regarding authorization approvals and PBM online applications
Refer coverage determination requests for specialty drugs to delegated vendor or client for processing
Contact providers for additional information to facilitate coverage determination reviews
Notify physicians, providers, and members of coverage determination request decisions
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules, and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Position Purpose:
Perform quality reviews to ensure high level of customer service and/or accuracy in processing claims and transactions.
Conduct procedural and quality reviews/audits to ensure adherence to policies and procedures and high levels of customer service, satisfaction, and accuracy using applicable tools and technologies
Provide written documentation to management regarding quality review/audit results
Collaborate with various cross-functional departments to identify training needs, system errors, processing errors, etc. and develop work plans and processes
Participate in continuous quality improvement initiatives and serve as a resource to others regarding quality concerns
Analyze data to ensure adjustments/changes yielded anticipated results
Assist with managing databases, policies and procedures related to assigned areas
Complete special projects as needed
10% travel may be required.
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Position Purpose:
Serve as a liaison between Customer Service Representatives CSRs), management and other various departments. Resolve customer inquiries via telephone and written correspondence in a timely and appropriate manner.
Investigate and resolve complex claims matters in coordination with health plan and/or corporate departments
Coordinate the day-to-day work functions, acting as a “go-to” person and investigating and resolving complex issues
Initiate change requests to resolve system configuration questions impacting claims processing; review and test results
Conduct appropriate auditing processes
Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits, and authorization status matters
Educate members and/or providers on health plan initiatives; train and assist providers regarding proper claims billing procedures
Provide first call resolution and “own the process” by working with appropriate internal/external resources and ensure the closure of all inquiries
Document all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application
Identify trends related to member and/or provider inquiries to respond proactively and provide feedback to management
Collaborate with other departments on cross-functional tasks and projects Maintain performance and quality standards based on established call center metrics including turn-around times Education/Experience: High school diploma or equivalent. Associates’ degree or equivalent 2 years higher education and/or work experience in Claims processing, billing, or coding experience preferred. 1.5+ years’ experience as a Customer Service Representative or previous Call Center, Healthcare, or insurance experience. Expert in understanding the working of a call center environment. Expert in customer service, verbal communication over the phone. 2+ years of experience in Medicare, Medicaid managed care or insurance environment preferred.
Remote Nationwide
Position Purpose:
Supervise the customer service workforce management function including forecasting, scheduling, call routing, service level management and business continuity. Support multiple functional areas with long-range planning, short-term scheduling, and real-time service level management. Ensure consistency of processes, optimization of systems, and achievement of performance metrics
Supervise all activities related to the workforce management function
Monitor all call activities at various call centers and make necessary staffing adjustments
Monitor agent productivity, identify gaps, and provide feedback to management
Evaluate and allocate staffing based on analysis of schedules, call volume, etc.
Assist with gathering requirements and RFP responses for new business
Identify staffing needs and forecasting for new business
Ensure consistency and accuracy between telephone and workforce management systems through audits
Monitor call center performance, analyze results against company objectives and campaigns and provide feedback and recommendations to management
Assist with the development of policies and procedures for the workforce department
Understand and translate business requirements into detailed system requirements for call center routing
Work with team to determine most effective call routing delivery to best able to handle specific call types
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