Customer Service Advocate I - MD Medicaid (Remote) jobs in United States
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CareFirst BlueCross BlueShield · 7 hours ago

Customer Service Advocate I - MD Medicaid (Remote)

CareFirst BlueCross BlueShield is seeking a Customer Service Advocate I to handle inquiries related to product information, benefits, claims resolution, eligibility, and billing in a call center environment. The role involves providing first-level problem resolution and accurate information to customers while maintaining records and participating in ongoing education.

Health CareNon ProfitService Industry
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Responsibilities

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

Qualification

Customer service experienceMedical terminologyPC navigation skillsData entry skillsInterpersonal communicationOral communicationWritten communicationEmpathetic communication

Required

High School Diploma or GED
Less than one year customer service experience
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 eligible to work in the U.S. without Sponsorship

Preferred

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

Benefits

Comprehensive benefits package
Various incentive programs/plans
401k contribution programs/plans

Company

CareFirst BlueCross BlueShield

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CareFirst. It’s not just our name. It’s our promise.

Funding

Current Stage
Late Stage

Leadership Team

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Ja'Ron Bridges
Interim President and Chief Executive Officer
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Doba Parushev
Vice President, Healthworx Ventures
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Company data provided by crunchbase