Customer Engagement Advocate II (Customer Service)

Lumen Solutions Group Inc. is a technology consulting Services company based in Florida, and they are seeking a Customer Engagement Advocate II to provide exceptional customer service in a fast-paced healthcare call center environment. The role involves handling inquiries related to benefits, claims, eligibility, billing, and healthcare products while ensuring a positive customer experience.

Responsibilities:

• Respond to inbound calls from members, providers, and brokers regarding healthcare products and services
• Research and resolve inquiries related to: Medical Claims, Benefits, Eligibility, Billing, Coverage Questions
• Investigate claim issues and verify claim accuracy, eligibility, and liability information
• Explain benefit plans, coverage limitations, and healthcare programs to customers
• Provide education regarding self-service tools, digital applications, and available healthcare resources
• Document customer interactions accurately within internal systems
• Deliver timely and accurate resolutions while meeting established service levels and performance metrics
• Manage multiple systems and applications while handling customer inquiries
• Provide basic technical support and troubleshooting assistance for online and digital platforms
• Escalate complex issues when appropriate and follow through to resolution

Requirements:

• High School Diploma or GED
• Minimum 3 years of customer service experience
• Experience working in a call center or high-volume customer support environment
• Strong verbal and written communication skills
• Excellent problem-solving and conflict-resolution abilities
• Strong computer navigation and data entry skills
• Ability to multitask and work effectively in a fast-paced environment
• Strong attention to detail and organizational skills
• Healthcare customer service experience
• Medical insurance experience
• Experience handling claims, benefits, eligibility, or billing inquiries
• Experience supporting members, providers, or brokers
• Familiarity with healthcare terminology and insurance concepts