Customer Service Advocate II (Remote)

Resonance CX Partners identifies and validates customer-focused opportunities for experienced professionals. We are not a staffing firm or agency.

About the role

Responsible for answering member, provider, and broker inquiries regarding product information, benefits, claims resolution, eligibility, and billing in a call center environment. Proactively educates members, providers, and brokers about health, financial, and self-service programs, and provides basic technical assistance for digital applications.

Responsibilities

• Provide first-level problem resolution to member, provider, and broker inquiries via telephone by researching information, examining claim submissions, verifying accuracy, and resolving issues based on policies and procedures.
• Use knowledge of products, services, and contractual provisions to interpret benefit utilization, limitations, and managed care initiatives.
• Administer services through telephonic, written, or electronic inquiries and claims adjustments.
• Document all client interactions according to departmental procedures.
• Prioritize workflow and multitask efficiently in a fast-paced environment.
• Deliver accurate information to customers in accordance with performance goals.
• Maintain customer advocate records by identifying needs and guiding customers to appropriate resources.
• Update account information using enrollment/inquiry tracking systems.
• Participate in system testing and ongoing education related to new services, industry topics, and skills.

Requirements

• High School Diploma or GED.
• 3 years of customer service experience.

Preferred Qualifications

• 3 years of experience in a call center customer service role.
• Experience with medical or insurance terminology.

Skills

• Empathetic and compassionate communication.
• Ability to quickly gain customer trust and confidence.
• Proficient PC navigation and data entry skills.
• Strong interpersonal, oral, and written communication skills.
• Ability to meet deadlines and handle multiple customer service demands.
• Effective communication and positive customer service, even with challenging customers.

Pay

Salary Range: $39,240 - $71,940 (adjusted for geographic differential and other factors such as experience, internal equity, and location).

Benefits

Comprehensive benefits package, various incentive programs/plans, and 401k contribution programs (all benefits/incentives are subject to eligibility requirements).