Service Advocate Jobs

Manage multiple dispute cases simultaneously in an efficient and effective manner in accordance with standard operating procedures

Minimum 2 years experience in Customer Service delivery roles with specific Escalations / Complaints experience

You champion the customer experience and can quickly form relationships and establish trust, respect, competence and confidence with our customers

Experience in service delivery in an Omnichannel environment and strong digital experience (Email, messaging and social media channels)

Excellent written and verbal communication skills

Paid Life insurance, AD&D, and disability benefits

We promote from within our diverse workforce regularly and offer regular opportunities to learn and grow

High school diploma or equivalent, additional customer service experience or training, required

Desire to increase knowledge, learn new systems and adopt new tools to enhance overall job performance

Benefits for the Client Advocate:

Qualifications for the Client Advocate:

Free Short-Term & Long-Term Disability insurance

Respond to, research and/or assist with priority inquiries and special projects as required by management

Provide feedback to management regarding customer problems, questions and needs

Maintain accurate records on complaints and/or other customer comments, and makes recommendations for changes to management

Follow through on complaints until resolved or reports to management as needed

Maintain basic knowledge of quality work instructions and company policies

1 year of claims processing or customer service experience OR Bachelor's Degree in lieu of work experience

Excellent verbal and written communication skills.

Strong human relations and organizational skills.

2 years-of customer service or call center experience.

Knowledge of word processing, spreadsheet, and database software.

Ensures effective customer relations by responding accurately, timely and courteously to telephone, written, web, or walk-in inquiries. Accurately documents inquiries.

Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments.

Sales or account management experience

3+ years of combined education, work and/or volunteer experience

Utilize time and resources effectively to achieve performance targets centered around a positive member experience

Participate in continuous learning and training sessions, developing new skillsets

High School Diploma / GED (or higher) OR equivalent work experience

Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)

Insurance, benefits, claims or medical/healthcare experience a plus, but not required.

Prior customer service experience working in a call center or in a position that entails handling calls is required.

Excellent communication skills necessary to be successful.

Please note that this position will be fully remote and open to those living within the U.S.

Handling call volumes averaging 30/calls per day and will be documenting all inquiries using our internal systems.

Working with your support team to appropriately refer unresolved inquiries or escalated calls based on customer service procedures and guidelines.

Meeting monthly service objectives as outlined by management

Essential Job Duties & Responsibilities

Offering prayer to all members and providers at every appropriate opportunity

Two (2) years customer service experience in a medical, dental, optical or related setting required

Two years high volume contact center experience preferred

Strong knowledge of computer hardware and software

5 years-of experience processing and adjudicating claims.

Knowledge of mathematical and statistical concepts.

Proficient in word processing and spreadsheet applications. proficient database software skills.

Preferred Software And Other Tools

We Prefer That You Have

Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient certification and/or prior authorization requests.

Initiates and manages clinical referrals for members.

What are your key responsibilities?

Acts as a liaison between hospitals, physicians, health plans, vendors, patients, or referral sources.

Verifies and obtains authorizations if needed. Enters referrals and documents communications, actions, and other data in departmental systems.

Refers cases requiring clinical review to appropriate clinical professionals.

Sales or account management experience

New York residents' salary range is $16.00 - $31.44, based on factors such as education, work experience, and certifications

3+ years of combined education, work, and/or volunteer experience

Respond to and resolve customer service inquiries and issues related to benefits, eligibility, claims, and financial spending accounts

High School Diploma / GED or equivalent work experience

Familiarity with medical terminology, health plan documents, or benefit plan design in a healthcare/insurance environment

Demonstrated organizational and communication skills required

Intermediate typing skills – 50 WPM strongly desired

Deep problem solving skills with demonstrated ownership of issue resolution

Possess top-notch people skills – listening, caring, connecting, empathy, and supporting

Strong skillset in the use of the suite of Microsoft Office tools strongly desired

Ability to multi-task, prioritize and effectively adapt to a fast paced changing environment required

Experience with premium payment and billing.

Prior experience working directly with members / consumers – preferably in a leading retail setting or call center setting.

Strong listening and interpersonal skills; skilled at developing and maintaining effective working relationships.

Ability to creatively solve members’ problems and have desire to help and advocate for them.

Ability to absorb and apply new and changing information.

Ability to make effective and independent decisions. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.