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CareFirst BlueCross BlueShield · 11 hours ago

Customer Service Advocate III (Remote)

United States

Full-time

Remote

Mid, Senior Level

$44K/yr - $81K/yr

5+ years exp

CareFirst BlueCross BlueShield is a healthcare organization, and they are seeking a Customer Service Advocate III. The role involves answering inquiries related to product information, benefits, and claims resolution while providing education and support to members, providers, and brokers in a call center environment.

Health CareNon ProfitService Industry

No H1B

Responsibilities

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

Maintains a more advanced knowledge of company products and services

Mentor and lead lower level Customer Service Advocates

Uses knowledge of products or services by collecting and the contractual provisions that govern administration to provide customer information service and analyzing education to interpret contractual language to the customer needs for the purpose of providing benefit utilization and limitations to determine the need for managed care initiatives and to administer all types of service to customers within the business segment through telephonic inquiries, written and/or electronic inquiries and claims adjustments if applicable

Appropriately documents all client interactions according to established departmental procedures

Resolves highly complex member, provider and broker inquires by gathering and investigating information; verifying customer understanding of information and resolves issues based on applicable policies and procedures; examine claim submissions verifying claim and system accuracy as well as liability

Prioritize workflow and multitask efficiently in a fast pace environment while using multiple skill sets with demonstrated high proficiency

Acts as the lead Customer Service Advocates to ensure that the team provides accurate and consistent information to inquiries in a courteous, timely, and professional manner

Mentors and coaches team on policies changes, system updates, learning tools, or other job requirements to provide a consistent base for new employees

Maintains a positive and enthusiastic attitude in an environment that requires teamwork, efficiency, cross-training, and continuous improvement

Ensures compliance with Standard Operating Procedures and serves as a resource to the staff

Qualification

Customer service experienceCall center experienceMedical terminologyPC navigation skillsInterpersonal communicationWritten communicationEmpathetic communication