Customer Experience Advocate Jobs

Roles and Responsibilities

The Customer Experience Advocate will handle calls from members and providers regarding various products including benefit plan design, medical claims status, network status, eligibility, billing and other general healthcare services questions as well as general questions regarding Healthcare Highways and affiliate companies.

• Spend approximately 90% of time on phones, averaging 60 to 80 calls per day
• Follow up with members and providers as necessary
• To fulfill this role, the Customer Experience Advocate will have experience in medical benefits, medical claims and employee eligibility
• Ability to utilize multiple computer and telephonic systems to provide effective resolution to member and provider questions
• Effectively respond to member and provider needs by either resolving their issues or ensure that they are triaged to the appropriate area to gain effective and efficient resolution.
• Answer questions and handle problem resolution on benefit, provider or claim issues
• Other duties may be assigned as necessary

Qualifications and Education Requirements

Candidate must have the below qualifications to be considered for this role:

• Two or more years of Healthcare experience in a health plan, provider network, insurance or employee benefit environment
• Strong PC skills - Word and Excel required
• Excellent communication skills
• Two or more years of medical billing experience (Preferred)
• Clear understanding of medical claims and claims administration
• Two or more years telephone customer service experience in a related field
• Bilingual preferred, but not required
• High school diploma required, college degree a plus

Hours

• 8 hour shift between the hours of 8:00 am to 5:00 pm
• Lunch: 30 min. or 1 hour, based on schedule

Preferred Skills

The characteristics below are critical to be successful in this role:

• Respond well in a stressful and dynamic environment
• Professional Appearance
• Flexible, uses critical thinking skills and open to learning new ideas/skills
• Ability to adapt communication style based on the caller's needs
• Team player
• A desire to help people
• Ability to multitask
• Positive attitude