[Remote] Account Advisor I - Call Center

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