Wellmark Blue Cross and Blue Shield

Customer Experience Advocate I (Customer Service)

United States US

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Job Description

Job Summary
Do you love sharing your compassion and empathy for others in the workplace? Is delivering a phenomenal customer experience important to you? Then its a great time to consider growing your career with Wellmark
Why Wellmark? We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!
About the opportunity: Our Operations division is currently seeking talented, dedicated, curious, and compassionate Customer Experience Advocates that are eager to serve as trusted partners. Your days will be filled with phone calls from our members and providers. Sometimes the work can be challenging and complex but will also be rewarding for those who want to make an impact by serving on the front lines to support our members. The Customer Experience Advocate will provide accurate, prompt, courteous, and professional responses to member and provider inquiries both over the phone and in writing, as well as review and process claims in accordance with established policies, procedures and contractual obligations. This role offers a distinctive development plan with promotional opportunities through our Customer Experience Advocacy program!
Aside from meaningful-challenging work, we offer:
• A strong focus on optimizing the customer experience – our mission is to Make Health Care Better!
• A culture of respect, diversity, inclusion, and commitment to our community
• A workplace that values health with access to a fitness facility, creative health programs, education, and services
• Exceptional employee benefits, rewards, and growth opportunities
• Best-in-class tuition assistance program (we will help pay off any current student loans you might have!)
The start date for this position is Monday, March 28th, 2022.
A 6-week virtual training is required for this opportunity. This training builds every day and prepares you to be comfortable and confident as a Customer Experience Advocate. With that said, we ask that you do not take any time off during this 6-week training program.
Hours for this position are 8:00 am - 5:00 pm. No nights or weekends!
This position does require reliable high-speed internet in your home.
Work from home order: The effects of COVID-19 have moved our employees to a work from home environment. This role will start out fully remote, but you will be expected to work from our office for a couple days per week upon our return. However, you will have flexibility to still work from home part of the week. The time in which we expect to return to our office is undetermined, but will take place when it is safe to do so.
• High School Diploma or GED.
• A minimum of 1-year proven experience engaging with customers (e.g. retail, service, health care provider, nursing, care giver, or teacher).
• Experience in customer centric role(s) with demonstrated ability to proactively develop professional customer relationships by listening, understanding, anticipating, and providing solutions to customer needs.
• Proven experience adapting to change.
• Strong written communication skills; with strong attention to detail (use of proper sentence structure, proper grammar, with the ability to synthesize member information into a consumable way).
• Experience in role where good judgment and proven problem-solving ability and ability to think independently while working with specified time constraints, such as first call resolution, average speed of answer, etc. has been demonstrated.
• Ability to resolve issues and conflicts in a professional manner while maintaining composure and confidence.
• Previous experience using multiple electronic systems and tools simultaneously, e.g. Internet, e-mail, MS. Office applications, etc.
• Prior experience in health insurance or related industry.
• Prior knowledge of health insurance related operations, such as claims, customer service and/or membership and enrollment including experience processing claims.
a. Apply customer engagement philosophies and personality based resolution techniques to all interactions. Integrate Wellmarks basic customer experience principles into daytoday interactions. Anticipate customers needs to make it easy to do business with Wellmark.b. Ensure information about Wellmarks products and services is clearly communicated by responding accurately, promptly and professionally. Advocate value based customer experience by handling calls relating to health benefits and claims payment inquiries.c. Develop and maintain positive member relationships with group members and providers by using Wellmark approved methodologies to understand, anticipate, and provide solutions to customer needs. Ensure customers understand their products, benefits, tools and how to use them.d. Ensure customer records i.e. claims, membership and/or billing are processed and updated timely and accurately. Identify and utilize appropriate resources to resolve customer inquiries.e. Responsible for the analysis and appropriate resolutions of claims related inquiries and processing. Will research, interpret and educate the customer regarding the claims and will then determine next steps required in order to accurately process claims and outstanding claims inquiries.f. Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs.g. Promote and educate on selfservice tools appropriately and accurately. Facilitate and teach customers to use appropriate resources/tools and how to access health care information to manage health care costs most effectively.h. Promptly follow up on all inquiries and document resolutions. Responsible for the accurate recording and documentation in Wellmarks system. Will document the type of contact, reason for the inquiry, and other tracking codes, which ensures the sharing of the customer experience, members concerns, and trends to the rest of the company. i. Other duties as assigned

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