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Customer Experience Advocate I 🔥


Job Description


This position is available to applicants in South Dakota only, with a fully remote option after successful completion of an 8-week onsite training as well as attendance and performance goals are met.

Do you love sharing your compassion and empathy for others in the workplace? Is delivering a phenomenal customer experience important to you? Then it's a great time to consider growing your career with Wellmark!

Why Wellmark? We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors–our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

About the opportunity: Our Operations division is currently seeking talented, dedicated, curious, and compassionate Customer Experience Advocates that are eager to serve as trusted partners. Your days will be filled with phone calls from our members and providers. Sometimes the work can be challenging and complex but will also be rewarding for those who want to make an impact by serving on the front lines to support our members. The Customer Experience Advocate will provide accurate, prompt, courteous, and professional responses to member and provider inquiries both over the phone and in writing, as well as review and process claims in accordance with established policies, procedures, and contractual obligations. This role offers a distinctive development plan with promotional opportunities through our Customer Experience Advocacy program!

Aside from meaningful-challenging work, we offer:

  • Ability to work fully remote after successful completion of an 8-week onsite training as well as attendance and performance goals are met.
  • A strong focus on optimizing the customer experience – our mission is to Make Health Care Better!
  • A culture of respect, diversity, inclusion, and commitment to our community
  • A workplace that values health with access to a fitness facility, creative health programs, education, and services
  • Exceptional employee benefits, rewards, and growth opportunities
  • Best-in-class tuition assistance program (we will help pay off any current student loans you might have!)

The start date for this position is Monday, December 19th, 2022.

An 8-week in person training is required from our Sioux Falls, South Dakota office. This training builds every day and prepares you to be comfortable and confident as a Customer Experience Advocate. With that said, we ask that you do not take any time off during this 8-week training program. During the training period Wellmark will observe December 23rd and 26th, as well as January 2nd and 16th as paid holidays.

Hours for this position are 8:00 am - 5:00 pm., Monday – Friday. No nights or weekends!

How do you do your best work? If selected for this position and after successful completion of an 8-week onsite training as well as attendance and performance goals are met, you will have the choice to work fully remote from home OR you can choose our hybrid work option which allows you to balance your time working at home with time at the office. Both options are designed to offer flexibility! *Please note that fully remote may still include occasional visits to a Wellmark office.

If you choose to work fully remote after the training, this role requires you to have your own reliable high-speed internet and a quiet, private space to take calls in your home.


Qualifications


Required:

  • High School Diploma or GED.
  • A minimum of 1-year proven experience engaging with customers (e.g. retail, service, health care provider, nursing, care giver, or teacher).
  • Experience in customer centric role(s) with demonstrated ability to proactively develop professional customer relationships by listening, understanding, anticipating, and providing solutions to customer needs.
  • Proven experience adapting to change.
  • Strong written communication skills; with strong attention to detail (use of proper sentence structure, proper grammar, with the ability to synthesize member information into a consumable way).
  • Experience in role where good judgment and proven problem-solving ability and ability to think independently while working with specified time constraints, such as first call resolution, average speed of answer, etc. has been demonstrated.
  • Ability to resolve issues and conflicts in a professional manner while maintaining composure and confidence.
  • Previous experience using multiple electronic systems and tools simultaneously, e.g. Internet, e-mail, MS. Office applications, etc.

Preferred:

  • Prior experience in health insurance or related industry.
  • Prior knowledge of health insurance related operations, such as claims, customer service and/or membership and enrollment including experience processing claims.

Additional Information


a. Apply customer engagement philosophies and personality based resolution techniques to all interactions. Integrate Wellmark’s basic customer experience principles into day-to-day interactions. Anticipate customers’ needs to make it easy to do business with Wellmark.

b. Ensure information about Wellmark’s products and services is clearly communicated by responding accurately, promptly and professionally. Advocate value based customer experience by handling calls relating to health benefits and claims payment inquiries.

c. Develop and maintain positive member relationships with group members and providers by using Wellmark approved methodologies to understand, anticipate, and provide solutions to customer needs. Ensure customers understand their products, benefits, tools and how to use them.

d. Ensure customer records (i.e. claims, membership and/or billing) are processed and updated timely and accurately. Identify and utilize appropriate resources to resolve customer inquiries.

e. Responsible for the analysis and appropriate resolution(s) of claims related inquiries and processing. Will research, interpret and educate the customer regarding the claim(s) and will then determine next steps required in order to accurately process claims and outstanding claims inquiries.

f. Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs.

g. Promote and educate on self-service tools appropriately and accurately. Facilitate and teach customers to use appropriate resources/tools and how to access health care information to manage health care costs most effectively.

h. Promptly follow up on all inquiries and document resolutions. Responsible for the accurate recording and documentation in Wellmark’s system. Will document the type of contact, reason for the inquiry, and other tracking codes, which ensures the sharing of the “customer experience,” members concerns, and trends to the rest of the company.

i. Other duties as assigned.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

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