Customer Service Advocate II (Remote)
CareFirst BlueCross BlueShield, Baltimore, MD, United States
Purpose
Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self‑service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.
Responsibilities
Provide first‑level problem resolution to member, provider and broker inquiries via telephone by gathering and researching information, examining claim submissions, verifying claim and system accuracy and resolving issues based on applicable policies and procedures.
Use knowledge of products or services and contractual provisions to provide customer information, interpret contractual language, determine the need for managed care initiatives, and administer all types of services to customers through telephonic, written or electronic inquiries and claims adjustments as applicable. Document all interactions according to established departmental procedures.
Prioritize workflow and multitask efficiently in a fast‑paced environment while using multiple skill sets with demonstrated proficiency.
Deliver accurate information to customers in accordance with performance goals and objectives.
Maintain customer advocate records by identifying underlying customer needs, guiding them to appropriate resources or programs, and updating account information by utilizing the business area enrollment/inquiry tracking system and processes.
Participate in system testing and ongoing education related to new services, industry topics, and skills.
Qualifications
Education Level : High School Diploma or GED.
Experience : 3 years customer service experience.
Preferred Qualifications : 3 years experience in a call center customer service role or experience with medical or insurance terminology.
Knowledge, Skills and Abilities
Demonstrated skills as an empathetic and compassionate communicator.
Ability to quickly gain customer trust and confidence.
PC navigation and data entry skills.
Strong interpersonal communication skills.
Good oral and written communication skills.
Must meet established deadlines and handle multiple customer service demands from internal and external customers within set expectations for service excellence. Must communicate positively with every internal and external customer, including those who may be demanding or otherwise challenging.
Salary Range
$38,448 - $70,488
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business considerations. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401(k) contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Department
ESSVS - Commercial Customer Service - Large Group Member
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disclosure / Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health‑care programs.
Physical Demands
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without sponsorship.
#J-18808-Ljbffr
Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self‑service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.
Responsibilities
Provide first‑level problem resolution to member, provider and broker inquiries via telephone by gathering and researching information, examining claim submissions, verifying claim and system accuracy and resolving issues based on applicable policies and procedures.
Use knowledge of products or services and contractual provisions to provide customer information, interpret contractual language, determine the need for managed care initiatives, and administer all types of services to customers through telephonic, written or electronic inquiries and claims adjustments as applicable. Document all interactions according to established departmental procedures.
Prioritize workflow and multitask efficiently in a fast‑paced environment while using multiple skill sets with demonstrated proficiency.
Deliver accurate information to customers in accordance with performance goals and objectives.
Maintain customer advocate records by identifying underlying customer needs, guiding them to appropriate resources or programs, and updating account information by utilizing the business area enrollment/inquiry tracking system and processes.
Participate in system testing and ongoing education related to new services, industry topics, and skills.
Qualifications
Education Level : High School Diploma or GED.
Experience : 3 years customer service experience.
Preferred Qualifications : 3 years experience in a call center customer service role or experience with medical or insurance terminology.
Knowledge, Skills and Abilities
Demonstrated skills as an empathetic and compassionate communicator.
Ability to quickly gain customer trust and confidence.
PC navigation and data entry skills.
Strong interpersonal communication skills.
Good oral and written communication skills.
Must meet established deadlines and handle multiple customer service demands from internal and external customers within set expectations for service excellence. Must communicate positively with every internal and external customer, including those who may be demanding or otherwise challenging.
Salary Range
$38,448 - $70,488
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business considerations. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401(k) contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Department
ESSVS - Commercial Customer Service - Large Group Member
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disclosure / Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health‑care programs.
Physical Demands
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without sponsorship.
#J-18808-Ljbffr