Job Details

Account Advisor

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

This role is a high-volume call center position. As an Account Advisor, you will spend most of your workday on the phone assisting members and providers with health planrelated questions.

What you will do day to day:

• Take approximately 4050 inbound calls per day
• Serve as the first point of contact for the organization
• Answer questions related to benefits, eligibility, claims, and general account issues
• Use multiple systems at one time while speaking with callers
• Follow established policies and scripts to provide accurate information
• Handle challenging or emotional calls professionally and calmly
• Document each call thoroughly before moving to the next one

Most calls are routine, but some can be complex or time-sensitive. You are expected to stay focused, manage your time, and move efficiently from call to call throughout your shift.

Work Schedule & Environment

• The Customer Service hours of operation are from 8am-5pm Monday-Friday.
• This is a remote position after training, with required onsite components during new hire training at the Baton Rouge Corporate Campus.
• You must be comfortable working a full shift on the phone, with scheduled breaks.
• A hardwired internet connection is required (minimum 5MB upload / 10MB download).

Qualifications Education

• High School Diploma or equivalent preferred

Work Experience

• 1 year of customer service or medical office experience required
• A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience
• Previous experience in a call center is preferred

Skills and Abilities

• Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook, etc.) and related software as other corporate software programs and applications.
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience, and professionalism.
• Familiarity with medical and health insurance terminology preferred
• Conflict resolution skills and remains calm under pressure/stressful situations
• Must be able to demonstrate critical thinking and problem solving skills
• Demonstrate attention to detail
• The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers.
• Reading comprehension skills are required due to the high amount of direct customer contacts and the need to understand customer contract benefits and training materials.
• Effective organizational and interpersonal skills are required. Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues.
• Ability to take ownership of issues from the beginning, seeking First Call Resolution (FCR)
• Must be able to verbally communicate on the telephone in a call center environment approximately 95% of the time in the Customer Care Center.
• Employees may be expected to work during inclement weather or other emergency situations when needed.
• Must have ability to successfully complete Customer Service training, with demonstrated proficiency in training materials.

Accountabilities and Essential Functions

• Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.
• Responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy, and customer satisfaction to members or providers.
• Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, and related computer systems to ensure information is current and accurate when providing service to members or providers on the telephone in the call center.
• Meet Customer Service performance goals/expectations in the areas of efficiency, accuracy, quality, production, customer satisfaction, and attendance
• The ability to verbally communicate on the telephone approximately 95% of the time.

An Equal Opportunity Employer