[Hiring] Customer Care Advocate @company

Role Description

The Customer Care Advocate (CCA) resolves customer inquiries via various channels concerning contract benefits, claim payments, and enrollment in accordance with LOS, Corporate Service strategy, NCQA, and legislative requirements. The CCA provides service for customers and business partners while enhancing member & provider satisfaction/retention. The B version of this role requires fluency in Spanish.

• Provides service among customers and business partners while enhancing member and provider satisfaction and retention.
• Documents, researches, interprets, and responds to inquiries from internal and external customers, business partners, and special groups concerning our products, services, and policies.
• Utilizes appropriate resources to resolve customer inquiries accurately & efficiently.
• Provides outreach related to claims, onboarding, effectuation, retention, provider inquiries, and other complex inquiries.
• Demonstrates willingness to adapt and be flexible to changes and business needs.
• Participates in meetings, training, and skill development to support career path and individual development plans.
• Is knowledgeable and enthusiastic about the company and our products and/or services.
• Identifies and follows through on issues impacting the Health Plan and customer experience.
• Develops effective internal working relationships for improved communication and collaboration.
• Shares ideas and solutions to improve processes, procedures, and systems.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values.
• Maintains high regard for member privacy in accordance with corporate privacy policies and procedures.
• Regular reliable attendance is expected and required.
• Performs other functions as assigned by management.

Qualifications

• High School diploma or equivalent, customer service experience preferred.
• Entry level position. Duties performed under close supervision.
• B Version: Bi-lingual English/Spanish required.
• Ability to multi-task to efficiently resolve customer concerns.
• Computer skills required, including the ability to navigate in a Windows environment.
• Organizational skills, reasoning, problem-solving skills, effective communication, and ability to prioritize.
• Successfully attends and completes all training as defined by the business unit.

Requirements

• Level II - in addition to Level I requirements:
• Rating of “Performing” or above on the Agent Dashboard for a minimum of 9 out of 12 months.
• Ability to efficiently resolve complex & escalated issues with minimal direction.
• Advanced system and navigational skills.
• Expanded communication skills across multiple channels.
• Takes accountability and ownership of issues and resolution with minimal supervision.
• Level III - in addition to Level II requirements:
• Rating of “Performing” or above on the Agent Dashboard for a minimum of 10 out of 12 additional months.
• Self-sufficient in resolving complex & escalated issues.
• Provide mentoring and support to new hires and peer group.
• Assist with tasks assigned by management that require advanced problem-solving skills.
• Demonstrates functional global thinking and takes initiative to recognize opportunities within the team.

Physical Requirements

• Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.
• The ability to hear, understand, and speak clearly while using a phone, with or without a headset.
• Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

Compensation Range(s)

Grade N2: Minimum $20.00 Maximum $20.00. The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications.