This role involves supporting members and provider inquiries about eligibility, claims, and payer information. You will collaborate with a supportive team, serve as a resource, and ensure customers and colleagues have a positive experience. Answer incoming phone calls from customers and identify the type of assistance needed (i.e., benefit and eligibility, billing and payments, authorizations for treatment, and explanation of member benefits (EOBs) and provider payments (EOPs). Serve as a resource for other team members or health plan customers. Respond to callers in a friendly and supportive manner with informed responses and next steps. Document call disposition and notes with accuracy and completeness within the system of record. Be an active and empathetic listener, asking appropriate questions to identify the primary reason for the call. Own problems through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up. Research complex issues across multiple databases and work with support resources to resolve customer issues. Meet performance goals in efficiency, call quality, provider satisfaction, first call resolution, and attendance. Handle protected health information (PHI) with strict confidentiality and diligence, adhering to all privacy protocols and HIPAA regulations. Identify improvement opportunities within the Call Center process. Receive rewards and recognition for performance in a challenging environment.