Account Advisor I – Remote LA (Hybrid Training)

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Requirements:

• Customer Service experience or equivalent
• Must be available to report to the Baton Rouge Corporate Campus for the onsite components of new hire training.
• Commitment to training program
• Hardwired internet connection with speeds greater than 5MB upload and 10MB download
• Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook , etc.) and related software as other corporate software progrms and applications.
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
• Familiarity with medical and health insurance terminology preferred
• Conflict resolution skills and remains calm under pressure/stressful situations
• Must be able to to demonstrate critical thinking and problem solving skills
• Demonstrate attention to detail
• The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers.
• Reading comprehension skills are required due to the high amount of direct customer contacts and the need to understand customer contract benefits and training materials.
• Effective organizational and interpersonal skills are required.
• Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues.
• Ability to take ownership of issues from the beginning, seeking First Call Resolution (FCR)
• Must be able to verbally communicate on the telephone in a call center environment approximately 95% of the time in the Customer Care Center.
• Must have ability to successfully complete Customer Service training, with demonstrated proficiency in training materials.

Responsibilities:

• Serve as first point of contact for the organization.
• Handle incoming calls from members and providers answering questions and offers guidance via the telephone with individuals in a prompt, courteous, and professional manner.
• Resolves benefit and claims inquiries received via the telephone, in person, or other acceptable receipt method from our members or providers in the call center .
• Promotes and maintains a positive company image through direct contact with customers.
• Complies with all laws and regulations associated with duties and responsibilities.
• Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.
• Responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members or providers.
• Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, and related computer systems to ensure information is current and accurate when providing service to members or providers on the telephone in the call center.
• Meet Customer Service performance goals/expectations in the areas of efficiency, accuracy, quality, production, customer satisfaction, and attendance
• The ability to verbally communicate on the telephone approximately 95% of the time.