Customer Advocate I (Kansas City area)

About the role

The Customer Advocate position is responsible for responding to a variety of inquiries from members and their dependents, hospitals, providers, attorneys, and agents. The incumbent will need to interpret multiple contracts in response to benefit and claim inquiries, research membership databases, and billing history to resolve membership issues.

Responsibilities

• Provides a high degree of customer service including receiving and responding to telephone calls, letters, or walk-in customers.
• Educates and works with members at different health literacy levels with cultural sensitivity.
• Enters record of inquiries and related correspondence in a computerized tracking system.
• Researches applicable medical policy and corporate, divisional, and department policies and procedures.
• Utilizes information, claims data, and membership records to resolve issues independently or with minimal assistance, when possible within the first call.
• Fully responsible for proactively maintaining knowledge base (e.g., start-up notes, emails, Blue Help updates).
• Maintains confidentiality of all regulated information in compliance with state and federal laws.
• Exemplifies professionalism by effectively using proper grammar and spelling when composing verbal and written correspondence that is customer-centric, compliant, and adapted to the audience.
• Recognizes trends or common issues and raises them to leadership as necessary, providing solution options as appropriate.
• Recognizes and uses time management techniques appropriately to manage competing projects and priorities to meet customer needs and deliver on commitments in a timely manner.
• Delivers a positive customer and member experience on a consistent basis.
• For FEP positions, must complete additional FEP training program for FEP system and procedures.
• Provides resolution with a service level that ensures members and customers feel valued and understood.

Requirements

• High school diploma or general education degree (GED).
• 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience.
• Advanced keyboarding knowledge.
• Intermediate knowledge of Microsoft Office.

Preferred Qualifications

• Associate’s degree from college or technical school.
• Previous experience with online customer service applications.
• Medical terminology and ICD/CPT coding knowledge.
• Experience taking Blue KC member calls.

Benefits

• Highly competitive total rewards package, including comprehensive medical, dental, and vision benefits.
• 401(k) plan with both employee and employer contributions.
• Annual incentive bonus plan based on company achievement of goals.
• Time away from work including paid holidays, paid time off, and volunteer time off.
• Professional development courses, mentorship opportunities, and tuition reimbursement program.
• Paid parental leave and adoption leave with adoption financial assistance.
• Employee discount program.