Customer Experience Advocate (Remote Available after Onsite Training) - Wellmark, Inc.

Do you love sharing your compassion and empathy for others in the workplace? Is delivering a phenomenal customer experience important to you? Then it's a great time to consider growing your career with Wellmark!

About the opportunity: Our Operations division is currently seeking multiple talented, dedicated, curious, and compassionate Customer Experience Advocates that are eager to serve as trusted partners.  Your days will be filled with phone calls from our members and providers. Sometimes the work can be challenging and complex but will also be rewarding for those who want to make an impact by serving on the front lines to support our members. The Customer Experience Advocate will provide accurate, prompt, courteous, and professional responses to member and provider inquiries over the phone, as well as review claims in accordance with established policies, procedures, and contractual obligations. This role offers a distinctive development plan with promotional opportunities through our Customer Experience Advocacy program, based on performance!

Aside from meaningful-challenging work, we offer: 

• Ability to work fully remote, upon meeting performance goals
• A strong focus on optimizing the customer experience – our mission is to Make Health Care Better!
• A culture of respect, diversity, inclusion, and commitment to our community
• A workplace that values health with access to a fitness facility, creative health programs, education, and services
• Exceptional employee benefits, rewards, and growth opportunities
• Best-in-class tuition assistance program (we will help pay off any current student loans you might have previously incurred!)

Start date & training:

The start date for this training class is Monday, August 26th. This position requires that you work onsite in the Des Moines, IA office for the duration of in-person training until you are effectively meeting attendance and performance goals, which could take up to 12 weeks. This training builds every day and prepares you to be comfortable and confident as a Customer Experience Advocate. With that said, we ask that you do not take any time off during this training program.

Hours:

Hours for this position are 8:00 am - 5:00 pm, Monday – Friday. No nights or weekends!

Working Remotely:

Once you have successfully completed onsite training and are effectively demonstrating attendance and performance expectations, you will have the flexibility to either work fully remote from home OR as hybrid, which allows you to balance working from home some days with working in the office other days. The choice is yours! Please note: If you choose to work fully remote after the training, this role requires you to have your own reliable high-speed internet and a quiet, private space in your home to discreetly take calls to ensure information confidentiality. Employees working fully remote will still be asked to report to a Wellmark office occasionally for key meetings, etc.

Required:

• High School Diploma or GED.
• A minimum of one year proven experience engaging with customers (e.g. retail, service, health care provider, nursing, care giver, or teacher).
• Experience in customer-centric role(s) with demonstrated ability to proactively develop professional customer relationships by listening, understanding, anticipating, and providing solutions to customer needs.
• Computer literacy – basic computer skills, such as accessing common web and desktop applications, navigating multiple sources of information and word processing.
• Professional verbal and written communication skills; attention to detail (use of proper sentence structure, proper grammar, with the ability to synthesize member information into a consumable format).
• Good judgment and proven problem-solving skills and ability to think independently.
• Ability to resolve issues and conflicts in a professional manner, while maintaining composure and confidence. Displays empathy and discerns stakeholders’ true intent.
• Collaborates with team members to accomplish goals or outcomes. Builds trust and connects with others, in order to complete work.
• Ability to adapt to an ever-changing work environment; ability to multitask and manage time.
• Basic math skills, including subtraction, addition and multiplication.
• Willingness to be trained on additional market segments, as business need dictates.
• Ability to come into the office when requested (i.e. team meetings, training, etc.).

Preferred:

• Associate degree
• Demonstrated experience working within specified time constraints, such as first call resolution, average speed of answer, etc.
• Prior experience and/or knowledge in health insurance or related industry.

a. Responsible for delivering an excellent customer experience for member, provider and other stakeholder inquiries via telephone in a contact center environment, while adhering to a structured schedule and meeting quality, attendance and production standards. Strives to provide first call resolution and de-escalates calls, as necessary.  

b. Apply customer engagement philosophies and personality-based resolution techniques to all interactions. Integrate Wellmark’s customer experience principles into day-to-day interactions. Anticipate customers’ needs to make it easy to do business with Wellmark.  

c. Ensure information about Wellmark’s products and services is clearly communicated by responding accurately, promptly and professionally. Advocate value-based customer experience by handling calls relating to health benefits, claims payment, etc. 

d. Develop and maintain positive relationships with members, providers and other stakeholders by using Wellmark-approved methodologies to understand, anticipate, and provide solutions to customer needs. Ensure customers understand their products, benefits, tools and how to use them. 

e. Ensure customer records (i.e. claims, membership and/or billing) are processed and updated timely and accurately. Identify and utilize appropriate resources to resolve customer inquiries. 

f. Responsible for the analysis and appropriate resolution(s) of claim-related inquiries and processing. Will research, interpret and educate the customer regarding the claim(s) and will then determine next steps required in order to accurately process claims and outstanding claims inquiries. 

g. Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs. 

h. Promote and educate on self-service tools appropriately and accurately. Facilitate and teach customers to use appropriate resources/ tools and how to access health care information to manage health care costs most effectively. 

i. Engaged and participate in team meetings, chat, corporate meetings, etc. 

j. Promptly follow up on all inquiries and document resolutions. Responsible for the accurate recording and documentation in Wellmark’s system. Will document the type of contact, reason for the inquiry, and other tracking codes, which ensures the sharing of the “customer experience,” members concerns, and trends to the rest of the company. 

k. Other duties as assigned. 

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

Please inform us if you meet the definition of a "Covered DoD official".