Customer Experience Advocate I - Individual Family Plan (IFP/ACA)

Wellmark, Inc. • Des Moines, IA

4h • Hybrid

About The Position

Our Operations division is currently seeking multiple talented, curious, and compassionate Customer Experience Advocates (CXA) that are eager to serve as trusted partners in navigating their health insurance needs Your days will be filled with phone calls from our members providers and other stakeholders. 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 CXA will provide accurate, prompt, courteous, and professional responses to member, provider or other stakeholder inquiries over the phone.
Aside from meaningful-challenging work, we offer:
An opportunity to work hybrid, upon meeting performance and system expectations
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 culture of individuals who are curious, committed, and connected
A workplace that values health with access to a fitness facility, health programs, education, and services
An opportunity for career advancement
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 previously incurred!)

Requirements

• 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.
• Computer literacy – basic computer skills, such as accessing common web and desktop applications, navigating multiple sources of information and word processing.
• Professional verbal and written communication skills; attention to detail (use of proper sentence structure, proper grammar, with the ability to synthesize member information into a consumable format).
• Good judgment and proven problem-solving skills and ability to think independently.
• Ability to resolve issues and conflicts in a professional manner, while maintaining composure and confidence. Displays empathy and discerns stakeholders’ true intent.
• Collaborates with team members to accomplish goals or outcomes. Builds trust and connects with others, in order to complete work.
• Ability to adapt to an ever-changing work environment; ability to multitask and manage time.
• Basic math skills, including subtraction, addition and multiplication.
• Willingness to be trained on additional market segments, as business need dictates.
• Ability to come into the office when requested (i.e. team meetings, training, etc.).

Nice To Haves

• Life and Health Insurance License
• Demonstrated experience working within specified time constraints, such as a structured schedule with adherence goals, etc.
• Prior experience and/or knowledge in health insurance or related industry.

Responsibilities

• Responsible for delivering an excellent customer experience for member, provider and other stakeholder inquiries via telephone in a contact center environment, while adhering to a structured schedule and meeting quality, attendance and production standards. Strives to provide first call resolution and de-escalates calls, as necessary.
• Apply customer engagement philosophies and personality-based resolution techniques to all interactions. Integrate Wellmark’s customer experience principles into day-to-day interactions. Anticipate customers’ needs to make it easy to do business with Wellmark.
• 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, claims payment, etc.
• Develop and maintain positive relationships with members, providers and other stakeholders 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.
• 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.
• Responsible for the analysis and appropriate resolution(s) of claim-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.
• Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs.
• 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.
• Engaged and participate in team meetings, chat, corporate meetings, etc.
• 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.
• Other duties as assigned.

Benefits

• An opportunity to work hybrid, upon meeting performance and system expectations
• 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 culture of individuals who are curious, committed, and connected
• A workplace that values health with access to a fitness facility, health programs, education, and services
• An opportunity for career advancement
• 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 previously incurred!)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED