Experienced Customer Advocate I-5 – Healthcare Innovations and Community Impact

Remote Full-time
At careerzynith, we're dedicated to making a difference in both your career and community. As a leading organization in the KC area, we're passionate about delivering innovative healthcare solutions that meet the evolving needs of our members. If you're interested in learning about healthcare professions and staying up-to-date on the latest healthcare innovations, we invite you to join our team as a Customer Advocate I-5.

**Job Summary:**

As a Customer Advocate I-5, you'll play a vital role in providing exceptional customer service to our members, hospitals, providers, attorneys, and agents. You'll be responsible for interpreting multiple contracts, researching membership databases, and resolving membership issues. Your primary goal will be to deliver a high degree of customer satisfaction, ensuring that our members feel valued and understood.

**Key Responsibilities:**

* Respond to a variety of inquiries from members and their dependents, hospitals, providers, attorneys, and agents in a timely and professional manner.
* Interpret multiple contracts in response to benefit and claim inquiries, ensuring accurate and compliant resolutions.
* Research membership databases and billing history to resolve membership issues, utilizing information, claims data, and membership records to resolve issues independently or with minimal assistance.
* Enter records of inquiries and related correspondence in our computerized tracking system, maintaining accurate and up-to-date records.
* Research applicable medical policy and corporate, divisional, and department policies and procedures to ensure compliance and effective resolution of issues.
* Utilize time management techniques to manage competing projects and priorities, delivering on commitments in a timely manner and meeting customer needs.
* Provide solution options as appropriate, recognizing trends or common issues and raising them to leadership as necessary.
* Maintain confidentiality of all regulated information in compliance with state and federal laws, exemplifying professionalism in all interactions.
* Deliver positive customer and member experience on a consistent basis, ensuring that our members feel valued and understood.

**Essential Qualifications:**

* 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.

**Preferred Qualifications:**

* Associates degree from college or technical school.
* Previous experience with on-line customer service applications.
* Medical terminology and ICD/CPT coding knowledge is preferred.

**Skills and Competencies:**

* Excellent communication and interpersonal skills, with the ability to interact with diverse groups, including members, hospitals, providers, attorneys, and agents.
* Strong analytical and problem-solving skills, with the ability to interpret complex contracts and resolve issues independently or with minimal assistance.
* Ability to work in a fast-paced environment, managing competing projects and priorities to meet customer needs and deliver on commitments in a timely manner.
* Strong time management and organizational skills, with the ability to maintain accurate and up-to-date records.
* Ability to maintain confidentiality of all regulated information in compliance with state and federal laws.
* Strong customer service skills, with the ability to deliver positive customer and member experience on a consistent basis.

**Career Growth Opportunities and Learning Benefits:**

At careerzynith, we're committed to helping our employees grow and develop their careers. As a Customer Advocate I-5, you'll have access to a range of training and development opportunities, including:

* Comprehensive onboarding program to ensure a smooth transition into the role.
* Ongoing training and development opportunities to enhance your skills and knowledge.
* Mentorship program to support your career growth and development.
* Opportunities for advancement to senior roles within the organization.

**Work Environment and Company Culture:**

At careerzynith, we're passionate about creating a positive and inclusive work environment that supports the well-being and success of our employees. Our company culture is built on the following values:

* Customer-centricity: We're committed to delivering exceptional customer service and ensuring that our members feel valued and understood.
* Innovation: We're passionate about staying ahead of the curve, embracing new ideas and technologies to improve the customer experience.
* Collaboration: We believe in working together as a team to achieve our goals and deliver exceptional results.
* Integrity: We're committed to acting with integrity, honesty, and transparency in all our interactions.

**Compensation, Perks, and Benefits:**

At careerzynith, we offer a competitive compensation package, including:

* Competitive salary and benefits package.
* Comprehensive health insurance, including medical, dental, and vision coverage.
* 401(k) retirement plan with company match.
* Paid time off, including vacation, sick leave, and holidays.
* Opportunities for professional development and career growth.

**How to Apply:**

If you're passionate about delivering exceptional customer service and making a difference in the lives of our members, we invite you to apply for the Customer Advocate I-5 role at careerzynith. Please submit your application through our website, including your resume and a cover letter outlining your qualifications and experience.

**Equal Opportunity Employer:**

careerzynith is an equal opportunity employer, committed to diversity, equity, and inclusion. We welcome applications from diverse candidates and are committed to creating a workplace that is inclusive and respectful of all employees.

**Accommodations:**

careerzynith will extend reasonable accommodations to qualified individuals with disabilities who are otherwise not able to fully utilize electronic and online job application systems. For assistance, please send an email to [HR Email].

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