Bilingual Customer Care Associate-San Antonio
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Plus, consider these perks: Benefits for full- and part-time employees, generous paid time off.
BASIC FUNCTION
- Responsible for assisting members in navigating the healthcare system by answering a variety of incoming calls and responding to members healthcare questions and issues; determine appropriate resolution to assist members based on their needs; transfer calls outside scope of responsibility to appropriate internal or external resource; verify/Collect appropriate demographic information and update in the appropriate system.
MAJOR JOB ACCOUNTABILITIES
Service Functions – Assist members in navigating the healthcare system by answering a variety incoming calls and responding to members healthcare questions and issues while ensuring adherence to department and corporate policies and procedures
- Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
- Determine appropriate resolution to assist members based on their needs
- Transfer calls outside scope of responsibility to appropriate internal or external resource
- Process calls in specific queue (e.g., triage, biometric, etc.) based on assignment
- Verify/Collect appropriate demographic information and update in appropriate system
- Follow-up with members, providers, insurance carriers and other vendors ensuring adherence to established policies
- Exercise exceptional customer service skills in an effort to optimize each contact with the member
- Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations
- Know and support approved departmental and corporate policies and procedures relating to benefit issues
- Ensure policies and procedures are in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
- Research Assistance - Assist in resolving routine program quality issues by identifying issue(s) and researching in a timely manner
- Follow research through until resolution
- Document all issues thoroughly maintaining department files
- Continuously evaluate the status of all work efforts, ensuring all tasks are prioritized to assist in providing timely and quality services
- Assist in monitoring issue trends, escalating such trends to supervisor to determine appropriate actions necessary to eliminate future occurrences and improve service levels
- Team Interfaces/Customer Service - Establish and maintain a professional relationship with
internal/external customers, team members and department contacts
- Cooperate with team members to meet goals or complete tasks
- Provide quality customer service that exceeds customer expectations and improves level of service being provided
- Treat all internal/external customers, team members and department contacts with dignity/respect
- Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided
MINIMUM QUALIFICATIONS
- Applicant for this job will be expected to meet the following minimum qualifications.
Education
- High School Diploma or G.E.D
- Associate's degree from an accredited college or university with major course work in business administration, liberal arts, healthcare or a related field preferred.
Experience
- Minimum of one year healthcare experience preferred.
Other
- Basic Knowledge of MS Word and Excel required
- Must score acceptably on job related testing
- Ability to pass standardized interview
- Based on assignment may need to be bilingual in English, Spanish, etc.
Knowledge of the following is preferred:
- Familiar with clinical clients processes and case handling
- A successful incumbent in the job will be able to demonstrate the following skills and abilities:
- Strong communication skills and phone etiquette
- Strong ability to explain complex issues to employees/retirees
- Highly effective listening skills
- Strong problems solving/issue resolution skills
- Excellent customer service and customer resolution skills
- Organizational and administrative skills
- Ability to work in a team environment