[Hiring] Service Advocate III @WebTPA

Role Description

The role of Service Advocate is focused on servicing current or potential customers (which are defined as members, providers, agents, brokers, benefit administrators or benefits consultants). Incumbents resolve questions and issues, help the Company's customers utilize products, tools and services and directly contribute to customer satisfaction and retention.

• Provide assistance to State members by responding to benefit and claim related inquiries via telephone and in writing.
• Utilize the Florida Blue Call Strategy to provide outstanding customer service and call resolution to our members; follow-up on issues to ensure resolution for customer.
• Educate and answer member questions on the access and use of member self-service tools.
• Perform research, request additional information from the provider, member and/or supporting plans if necessary, and make decisions to return, pend, pay or deny low risk claims in order to properly adjudicate claims and inquiries within contract benefit and claims processing guidelines.
• Evaluate data through questioning, probing, and reasoning for process improvements.
• Research and resolve service-related inquiries for members and providers, meeting established expectations for quality, productivity and timeliness.
• Provide customer service and education to plan members and providers by answering more complex questions regarding insurance claims and policies, resolving issues and ensuring customers understand the Company’s products, services and processes.
• Work across multiple business areas and utilize various systems, tools, and resources to resolve service inquiries.
• Ability to work an assigned shift between 7:00 AM and 7:00 PM, Monday – Friday with occasional overtime, weekends and holidays as business needs require.
• Complete assigned training class successfully.

Qualifications

• 0-1 year of related work experience or equivalent combination of transferable experience and education.
• Ability to resolve/respond to customer inquiries and concerns, using sound problem solving and decision-making skills.
• Demonstrated empathy and compassion, with outstanding listening and communication skills.
• High school diploma or GED.

Requirements

• 1 or more years work experience related to Health Insurance claims or Health Insurance customer service (preferred).
• Sedentary work: Exerting up to 10 pounds of force occasionally to move objects.

Benefits

• Medical, dental, vision, life and global travel health insurance.
• Income protection benefits: life insurance, short- and long-term disability programs.
• Leave programs to support personal circumstances.
• Retirement Savings Plan including employer match.
• Paid time off, volunteer time off, 10 holidays and 2 well-being days.
• Additional voluntary benefits available.
• A comprehensive wellness program.
• Competitive pay with opportunities for incentive or commission compensation.
• Regular annual reviews with pay for performance considerations for base pay increases.