Medicare Customer Satisfaction Advocate I - Mindlance : Job Details

Summary Description: Under the general direction of the Supervisor, performs a variety of functions including responding to all member inquires through incoming phone calls, faxes, email and written correspondence, providing accurate responses in a timely manner. Accountable for providing a positive member experience by consistently showing professionalism, empathy and respect in their interactions with both internal and external customers. In accordance with established policies and procedures, performs a variety of administrative and member support tasks. Responsible for contributing to meeting and/or exceeding the service level goals and compliance in accordance with corporate performance guidelines and standards set forth by the Medicare Division and the Centers for Medicare and Medicaid Services. Accountable for meeting individual performance goals established by management. Essential Resource Responsibilities / Accountabilities: Level I - Participates in the training needed to learn regulations, legacy systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job - Responsible for maintaining accurate and up-to-date knowledge of all Medicare Advantage regulations and possess the ability to communicate to members in a clear and concise manner to ensure understanding of the products - Including but not limited to competitive plans, health care financing, CMS, and trends and concepts that impact managed health care - Demonstrates a thorough understanding of the Grievance & Appeal process and timeframes - Demonstrates a complete and thorough understanding of all subscriber agreements, amendments, marketing materials, and program - Researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with CMS, NCQA and legislative requirements - Continues to develop necessary skills to expertly, accurately and efficiently resolve customer inquiries in an organized manner, resulting in acceptable accuracy and production levels, and retention of subscriber contracts - Deals effectively with upset customers in an empathetic and professional manner and takes responsibility for conflict resolution - Responds to customers in a professional, efficient manner to encourage public acceptance of corporate products, services, and policies - Identifies patterns generated by external and internal action effecting customer satisfaction - Identifies and follows through on potential issues affecting the insurance industry Minimum Resource Qualifications: Level I - Post-secondary education with the equivalent of 2-4 years formal education/training and/or public business experience - A Bachelors degree is preferred - Effective and diplomatic communication skills including oral, written and listening- Organizational, reasoning and problem solving skills - Strong keyboarding and PC Skills required - Knowledge of coverage and lines of business products, services and policies - Medical terminology is desirable Physical Requirements: - Must be able to function for long lengths of time sitting at a desk using a keyboard. - Will need the ability to use a headset to listen to customer conversations In support of the Americans with Disabilities Act, this resource requirements document lists only those responsibilities and qualifications deemed essential to the position Equal Opportunity Employer: Excellus Client Client is an Equal Opportunity Employer. As such, requires all suppliers of temporary staffing resources to affirm the rights of every person to participate in all aspects of employment without regard to race, color, sex/gender, age, disability, religion, creed, citizenship status, national origin, veteran status, military status, marital status, familial status, domestic violence victim status, sexual orientation, gender identity, predisposing genetic characteristic, genetic information, or any other status protected under the law EEO: Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of - Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.