Customer Service Advocate I- Md July - Baltimore, United States - CareFirst BlueCross BlueShield

Mark Lane

Posted by:

Mark Lane

beBee recruiter


Description

Resp & Qualifications

PURPOSE:


ESSENTIAL FUNCTIONS:


  • Provides first
- level problem resolution to member, provider & broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolves issues based on applicable policies and procedures.

  • Uses knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer 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.
  • Delivers accurate information to customers in accordance with performance goals and objectives.
  • Maintains customer records by updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes.
  • Participates in ongoing education related to new services, industry topics, and skills.

QUALIFICATIONS:


Education Level:
High School Diploma or GED.


Experience:
Less than one year customer service experience.


Preferred Qualifications:


  • Less than 1 year experience in a call center customer service role or experience with medical or insurance terminology.

Knowledge, Skills and Abilities (KSAs)

  • Successful completion of the training provided.
  • 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. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range:
$30,312 - $55,572


Salary Range Disclaimer

Department
NASCO Commercial Member Services


Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.

It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.


Where To Apply

Federal Disc/Physical Demand

Note:

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.


PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.


Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship

More jobs from CareFirst BlueCross BlueShield