[Hiring] Consumer Care Advocate @eTeam

Role Description

The shifts available are listed below and are CST. A written agreement from the agents regarding their shift will be required. This position can be remote. Note your workers location and their shift preference on top of resume.

• Shift Preference:
• 4x10 Mon-Wed, Friday 8:00 am-7:00 pm
• 5x8 Monday-Friday 10:30 am-7:00 pm (2 of these or the 4x10 provided)
• 5x8 Monday-Friday 9:30 am-6:00 pm

PRIMARY PURPOSE: To provide high quality service to both internal and external customers, delivering an easy and efficient customer experience for routine lost time.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES:

• Processes incoming calls, faxes and voicemails from claimants, providers, clients, attorneys, etc., resolving their claims related questions and issues in accordance with designed guidelines and policies.
• Communicates claims status and current claim activity with client and appropriate medical contact; responds to inquiries about jurisdiction- and claim-specific issues.
• Enters data into claims system(s) and ensures claim files are properly documented and claims coding is correct.
• Coordinates claimant address updates or changes with internal departments.
• Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate and coordinates independent medical examinations.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES:

• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

• High school diploma or GED required.
• Associate’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Two (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.

Requirements

• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Strong investigation and organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance.