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Job Summary

Customer Advocate I supports our individual customers (under 65 and over 65) by providing the highest level of service, support, and education for comprehensive enrollment, membership, benefits and claims information to individuals and groups depending on the marketing service area. Incumbent must be professional, courteous, and provide outstanding customer service while maintaining a thorough knowledge of products, providing accurate information regarding claims processing and procedures, contract benefits, coordination of benefits, provider networks, and membership criteria; along with assisting retail customers with questions related to billings, collection of premium payments, and other related services.

Requirements

EDUCATION

High school diploma or equivalent.

LICENSING/CERTIFICATION

Arkansas Health and Life Insurance License preferred. If licenses are not previously held, must successfully pass both health and life exams within three (3) months after coursework is assigned.

Exchange producer license preferred.

CMS certification for senior products preferred.

EXPERIENCE

Minimum three (3) years’ experience in customer service or sales administration experience, preferably in the insurance industry, health insurance agency or provider's office.

ESSENTIAL SKILLS & ABILITIES

Customer Service

Problem Solving

Oral & Written Communication

Interpersonal Communication

Professional Judgment

Highly Organized

Proficiency using Microsoft Word and Excel.

Ability to work independently or with a team.

Skills

• Active Listening • Customer Service • Oral Communications • Performing Administrative Activities • Personal Organization • Problem Sensitivity • Problem Solving • Process Information • Researching • Results Interpretation • Social Perceptiveness • Teamwork

Responsibilities

• Answers high volume calls from members, providers, agents and billing services. Ensures timely, accurate and courteous response to inquiries and questions. Creates a solid working relationship with all groups by working directly with contacts as needed to resolve issues. • Complies with retail dress and appearance standards while working retail hours as described by management. • Consults with prospects on individual product options and determine appropriate coverage options based on coverage needs and financial status, and assists customers with completing applications necessary to apply for coverage. Promotes all products sold by the enterprise. • Establishes premium payment arrangements for members. Accepts and processes premium payments. • Performs other duties as requested. • Provides comprehensive enrollment, membership, benefits & claims information for both group & individual products (depending on marketing area). Stays informed of all changes in benefits, regulations, and guidelines. • Provides support to retail sales representatives.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

2.2 General Office Worker, Semi-Active, Local Travel - someone who normally works in an office setting or remotely, periodically has lifting and carrying requirements up to 40 lbs and routinely travels for work within the metropolitan area by vehicle as essential functions of the job.