SAL Advocate – Bilingual
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Job Description
Member advocate providing support for benefits, eligibility, and claims. Ensuring satisfaction through superior customer service and follow-up with members.
Responsibilities:
- Serves members by being an advocate and point of contact for member questions and concerns regarding benefits, eligibility, referrals, claims and any other aspects of plan benefits and services.
- Ensures member satisfaction by providing superior customer service and willingness to help at all times while maintaining a professional demeanor.
- Provides quality customer service by applying SCAN Five Service Principles.
- Educates members, family, providers and caregivers regarding benefits and plan options.
- Accurately explains benefits and plan options in person, via email or telephonically.
- Provides follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution.
- Escalates appropriate member issues to management or other departments as required.
- Consistently meets and/or exceeds the departmental standards, including, but not limited to: quality, productivity, and adherence to schedule and attendance.
- Responds appropriately and in a timely fashion to member/internal staff/providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures and job aids.
- Takes ownership of the issue, focusing on providing solutions and options for members, as necessary through resolution of member issues.
- Increases member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion; coordinates resolution with providers and other departments as needed.
Requirements:
- 1-2 years call center or related customer service experience, required.
- 1-2 years of prior experience with Medicare benefits, including Medicare Advantage Plans preferred.
- Ability to maintain calm demeanor at all times, including during highly charged situations.
- Data entry and general computer skills (word processing, e-mail) required.
- Effective communication (oral and written) skills.
- Professional/pleasant telephone manner required.
- Ability to handle large call volume, while providing excellent customer service at all times required.
- Demonstrated efficiency/effectiveness in an environment with a high call volume.
- Experience in the healthcare, insurance or pharmacy industry high desirable.
Benefits:
- Base Pay Range: $20.75
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)- 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
- Excellent 401(k) Retirement Saving Plan with employer match
- Robust employee recognition program
- Tuition reimbursement
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