Note: The job is a remote job and is open to candidates in USA. Louisiana Health Service & Indemnity Company is seeking an Account Advisor I for their call center. The role involves assisting members and providers with health plan-related inquiries and handling a high volume of calls while ensuring accurate information is provided and documented.
Responsibilities
- Take approximately 40–50 inbound calls per day
- Serve as the first point of contact for the organization
- Answer questions related to benefits, eligibility, claims, and general account issues
- Use multiple systems at one time while speaking with callers
- Follow established policies and scripts to provide accurate information
- Handle challenging or emotional calls professionally and calmly
- Document each call thoroughly before moving to the next one
- Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy
- Responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members or providers
- Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, and related computer systems to ensure information is current and accurate when providing service to members or providers on the telephone in the call center
- Meet Customer Service performance goals/expectations in the areas of efficiency, accuracy, quality, production, customer satisfaction, and attendance
- The ability to verbally communicate on the telephone approximately 95% of the time
Skills
- High School Diploma or equivalent preferred
- 1 year of customer service or medical office experience required
- A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience
- Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook, etc.) and related software as other corporate software programs and applications
- Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism
- Conflict resolution skills and remains calm under pressure/stressful situations
- Must be able to demonstrate critical thinking and problem solving skills
- Demonstrate attention to detail
- The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers
- Reading comprehension skills are required due to the high amount of direct customer contacts and the need to understand customer contract benefits and training materials
- Effective organizational and interpersonal skills are required. Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues
- Ability to take ownership of issues from the beginning, seeking First Call Resolution (FCR)
- Must be able to verbally communicate on the telephone in a call center environment approximately 95% of the time in the Customer Care Center
- Employees may be expected to work during inclement weather or other emergency situations when needed
- Must have ability to successfully complete Customer Service training, with demonstrated proficiency in training materials
- The ability to verbally communicate on the telephone approximately 95% of the time
- Residency in or relocation to Louisiana is preferred for all positions
- Previous experience in a call center is preferred
- Familiarity with medical and health insurance terminology preferred
Company Overview