Position Purpose: Responsible for resolving provider and customer inquiries via telephone and written correspondence in a timely and appropriate manner.Knowledge/Experience: High School education or equivalent. Minimum of 3 years of experience in healthcare or insurance customer service and 1 year of managed care experience. Must be bilingual, cross trained in another major functional area within the business unit, or have relevant knowledge to handle special projects.Competencies: Team Member: Integrity, Flexibility, Communication, Critical Thinking, Quality Orientation, Building Customer Loyalty, Building Strategic Working Relationships, Contributing to Team SuccessPosition Responsibilities:•Answer and document all calls for reporting and resolution through appropriate phone log system. •Answer phone inquiries from providers regarding claim, eligibility, covered benefits, authorization status and pharmacy issues. •Complete Provider Addition, Change and Termination Forms (PACTs) and Customer Service Forms (CSFs) and claims projects as assigned in a timely manner. Complete appropriate auditing process. •Respond proactively to provider issues and concerns and give feedback to management. •Initiate or fax necessary forms to provider to release pending claims. •Follow up on weekly open phone log report to make sure that CSFs have been resolved timely and accurately. •Assist external representatives. •Work with other departments on cross functional tasks and projects