U.S. Department of Labor

Customer Advocate I

U.S. Department of Labor

full-time

Posted on:

Location Type: Remote

Location: United States

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About the role

  • The Customer Advocate position is responsible for responding to a variety of inquiries from members and their dependents, hospitals, providers, attorneys and agents.
  • The incumbent will need to interpret multiple contracts in response to benefit and claim inquiries.
  • Researches membership database and billing history to resolve membership issues.
  • Provides a high degree of customer service including receiving and responding to telephone calls, letters or walk-in customers.
  • Educates and works with members at different health literacy levels with cultural sensitivity.
  • Enters record of inquiries and related correspondence in computerized tracking system.
  • Researches applicable medical policy and corporate, divisional, and department policies and procedures.
  • Utilizes information, claims data, and membership records to resolve issues independently or with minimal assistance, when possible within first call.
  • Fully responsible for proactively maintaining knowledge based (i.e. start-up notes, emails, Blue Help updates, etc.)
  • Maintains confidentiality of all regulated information in compliance with state and federal laws.
  • Exemplifies professionalism by effectively using proper grammar and spelling when composing verbal and written correspondence that is customer centric, compliant, and adapted to audience.
  • Recognizes trends or common issues and raises to leadership as necessary.
  • Provides solution options as appropriate.
  • Recognizes and uses time management techniques appropriately to manage competing projects and priorities to meet customer needs and deliver on commitments in a timely manner.
  • Delivers positive customer and member experience on a consistent basis.

Requirements

  • High school diploma or general education degree (GED).
  • 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience
  • Advanced Keyboarding Knowledge
  • Intermediate knowledge of Microsoft Office
  • Associates degree from college or technical school (preferred).
  • Previous experience with on-line customer service applications (preferred).
  • Medical terminology and ICD/CPT coding knowledge (preferred).
  • Experience taking Blue KC member calls (preferred).
Benefits
  • Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
  • Annual incentive bonus plan based on company achievement of goals
  • Time away from work including paid holidays, paid time off and volunteer time off
  • Professional development courses, mentorship opportunities, and tuition reimbursement program
  • Paid parental leave and adoption leave with adoption financial assistance
  • Employee discount program
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
customer serviceclaims processingadvanced keyboardingMicrosoft Officemedical terminologyICD codingCPT codingonline customer service applicationsmembership database researchbilling history resolution
Soft Skills
cultural sensitivityprofessionalismcommunicationtime managementproblem-solvingtrend recognitioncustomer-centric approachindependent workadaptabilityattention to detail
Certifications
high school diplomaGEDassociates degree