Customer Service Advocate IV

Role Overview

• Performs as the advocate that focuses on resolving complex issues or concerns for members or providers.
• Leverages a variety of communication channels to provide members or providers with timely, accurate, and personalized resolutions on complex complaints and escalations.
• Assesses and researches customer service needs, determines causes, and initiates corrective actions to other service or technical departments for follow up as needed.
• Provides guidance on various complex member or provider issues to resolve customer’s inquiries or requests.
• Provides member or providers with information and resources to further educate relevancy to the complex inquiry or concern.
• Provides customer service in a high pace contact center environment over the phone, via live chats and emails.
• Continues to develop in-depth knowledge and deep expertise in multiple additional markets and/or plans in multiple subject areas and responds to complex or escalated questions.
• May lead the team in member or provider request resolution and collaborates inter-departmentally to resolve inquiries or concerns.
• Identifies, documents and resolves all customer information and communications and updates leadership on customer needs thru root cause analysis, recommendation and resolution.
• Collaborates with training teams to develop training materials and/or programs to ensure quality and adherences to policies and procedures.
• Records all activities for quality and metrics reporting through the Customer Relationship Management (CRM) application, including customer interactions, details of inquiries, complaints, comments, and final resolution.
• Adheres to quality standards, regulations, and confidentiality through the various communication channels.
• Participates in special projects as needed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Requirements

• High School diploma or GED
• 4+ years of related experience
• vocational or technical education may include additional on-the-job training or continuous learning education preferred.
• experience working in AWS, Omni, CenPas, Amisys preferred

Tech Stack

• AWS

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules