Customer Engagement - Advocate, Customer Service II

Customer Engagement - Advocate, Customer Service II

Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.

Key Responsibilities:

• 35% Provides first-level problem resolution to member, provider and broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolves issues based on applicable policies and procedures.
• 20% Uses knowledge of products or services by collecting and interpreting contractual provisions to provide customer information service and analyze education. Administers services through telephonic, written, and/or electronic inquiries and claims adjustments, if applicable. Appropriately documents all client interactions according to established procedures.
• 15% Prioritize workflow & multitask efficiently in a fast-paced environment while using multiple skill sets with demonstrated proficiency.
• 15% Delivers accurate information to customers in accordance with performance goals and objectives.
• 10% Maintains customer advocate records by identifying underlying customer needs and guiding them to appropriate resources or programs, updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes.
• 5% Participates in ongoing education related to new services, industry topics, and skills.

Required Qualifications:

• High School Diploma or GED
• 3 years customer service experience
• Call Center Experience

Preferred Qualifications:

• Medical Insurance background (a plus but not required)

Knowledge, Skills, and Abilities (KSAs):

• Demonstrated skills as an empathetic and compassionate communicator.
• Ability to quickly gain customer trust and confidence.
• Demonstrated PC navigation and data entry skills.
• Strong interpersonal communication skills.
• Good oral and written communication skills.

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.