Customer Experience Advocate

Crawford & Company•United States,

3h•Remote

About The Position

The Customer Experience Advocate serves as a support contact for clients and their employees, handling calls and emails professionally and resolving issues in one contact when possible. The role focuses on disability and leave claims, providing a positive customer experience while working in a fast-paced environment. The Advocate responds to pilot line calls and email communications, manages and authorizes claim payments, gathers information from claimants, employers, and medical professionals, and applies contractual provisions, case-management resources, and claim processes to assess eligibility and liability. The role also de-escalates calls referred by Absence Specialists, assists with training new employees as needed, and upholds the Crawford Code of Conduct.

Requirements

High school diploma.
Two years of STD/LTD claims adjudication experience.
Ability to learn medical terminology and conditions.
Ability to interpret procedures and regulations.
Knowledge of Excel, Word, and web-based systems.
Excellent verbal and written communication skills.
Knowledge of ERISA regulations, required offsets and deductions, disability duration, and Social Security procedures.
Demonstrated ability to gather and analyze information, determine a course of action, and implement the selected course of action.
Strong ability to identify, analyze, and solve problems.
Effective interpersonal skills, including the ability to deal with external sources and all levels of employees.

Nice To Haves

Experience in TPA or self-administration services.
Experience with FMLA/State leave claims.

Responsibilities

Respond to pilot line calls and email communications with reactionary responses within the claim.
Manage and authorize claim payments while meeting service, timeframe, and production standards.
Communicate with claimants, employers, and medical professionals to gather information about eligibility, benefit authorization, and ongoing benefit management.
Apply contractual provisions, case-management resources, and claim processes to ensure accurate eligibility requirements and liability decisions.
De-escalate calls submitted by Absence Specialists.
Provide excellent customer service and industry knowledge in response to inquiries.
Assist in training new employees as needed.
Perform other duties as assigned.
Uphold the Crawford Code of Conduct.