Customer Care Advocate IA - Buffalo

Customer Care Advocate

The Customer Care (CC) Advocate resolves customer inquiries via telephone, walk in, mail, fax, web chat, off-phone work, and email concerning, but not limited to, contract benefits, claim payments, and enrollment in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements. The Customer Care Advocate provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance member & provider satisfaction / retention. The B version of this role requires the individual to speak Spanish fluently.

Essential Responsibilities / Accountabilities :

All Levels

• Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance member and provider satisfaction and retention. Must exercise tact, patience, and professionalism at all times in responding to internal / external customers.
• Documents, researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with MTM, NCQA, HIPAA, NYSDOH, CMS and other legislative requirements.
• By utilizing appropriate resources, resolves customer inquiries accurately & efficiently resulting in acceptable quality, First Contact Resolution, and performance.
• Provides outreach related to claims, onboarding, effectuation, retention, provider inquiries, and any other complex inquiry.
• Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution.
• Ongoing participation in meetings, training, and skill development to support career path and individual development plans.
• Is knowledgeable and enthusiastic about the company and our products and / or services.
• Identifies and follows through on issues impacting the Health Plan and customer experience.
• Develops effective internal working relationships for improved communication and collaboration.
• Shares ideas and solutions to improve processes, procedures, and systems.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular reliable attendance is expected and required.
• Performs other functions as assigned by management.

Minimum Qualifications :

NOTE : We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and / or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

Level I :

Level II - in addition to Level I requirements :

Level III - in addition to Level II requirements :

Physical Requirements :

The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE :

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s) : Grade N2 : Minimum $18.22 - Maximum $23.89

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and / or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note : The opportunity for remote work may be possible for all jobs posted by the Univera Healthcare Talent Acquisition team. This decision is made on a case-by-case basis.