Customer Service Advocate II (Remote)

About the role

Responsible for answering member, provider, and 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, and brokers about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.

Responsibilities

• Provides first-level problem resolution to member, provider, and broker inquiries via telephone by gathering and researching information; examines claim submissions verifying claim and system accuracy as well as liability, validates customer understanding of information, and resolves issues based on applicable policies and procedures.
• Uses knowledge of products or services by collecting and analyzing contractual provisions to interpret contractual language, provide customer education, and determine benefit utilization and limitations.
• Administers all types of services 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.
• Prioritizes workflow and multitasks efficiently in a fast-paced environment while using multiple skill sets with demonstrated proficiency.
• Delivers accurate information to customers in accordance with performance goals and objectives.
• Maintains customer advocate records by identifying underlying customer needs and guiding them to appropriate resources or programs; updates account information by effectively utilizing the business area’s enrollment/inquiry tracking system and processes.
• Participates in system testing as needed 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 or experience with medical or insurance terminology.

Skills

• Demonstrated skills as an empathetic and compassionate communicator.
• Ability to quickly gain customer trust and confidence.
• Demonstrated PC navigation and data entry skills.
• Strong interpersonal communication skills.
• Good oral and written communication skills.
• Ability to meet established deadlines and handle multiple customer service demands from internal and external customers within set expectations for service excellence.
• Ability to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Pay

Salary Range: $39,240 - $71,940

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 considers factors such as scope and responsibilities of the position, 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 experience, internal equity, and location.

Benefits

In addition to compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Must be eligible to work in the U.S. without sponsorship.