Account Advisor I - Call Center

Blue Cross and Blue Shield of Louisiana•Remote-LA, LA

6d•Hybrid

About The Position

This role is a high-volume call center position. As an Account Advisor, you will spend most of your workday on the phone assisting members and providers with health plan-related questions. You will take approximately 40-50 inbound calls per day, serving as the first point of contact for the organization. You will answer questions related to benefits, eligibility, claims, and general account issues, using multiple systems simultaneously while speaking with callers. You will follow established policies and scripts to provide accurate information and handle challenging or emotional calls professionally and calmly, documenting each call thoroughly. Most calls are routine, but some can be complex or time-sensitive. You are expected to stay focused, manage your time, and move efficiently from call to call throughout your shift. Employees may be expected to work during inclement weather or other emergency situations when needed. Must have the ability to successfully complete Customer Service training, with demonstrated proficiency in training materials.

Requirements

1 year of customer service or medical office experience required
Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook , etc.) and related software as other corporate software progrms 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 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.
A hardwired internet connection is required (minimum 5MB upload / 10MB download).

Nice To Haves

Residency in or relocation to Louisiana is preferred for all positions.
High School Diploma or equivalent preferred
A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience
Previous experience in a call center is preferred
Familiarity with medical and health insurance terminology preferred

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
Stay focused, manage your time, and move efficiently from call to call throughout your shift
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.