Account Advisor I - Call Center

Summary

Louisiana Blue is seeking an Account Advisor I to serve members and providers in a high-volume health insurance call center. The role handles inbound inquiries about benefits, eligibility, claims, billing, payments, and account issues while documenting calls, researching multiple systems, and meeting customer service performance goals.

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

• 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 progrms 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 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
• High School Diploma or equivalent preferred
• Previous experience in a call center is preferred
• Familiarity with medical and health insurance terminology preferred

Qualifications

Must Haves

• 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 progrms 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 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

Nice to Haves

• High School Diploma or equivalent preferred
• Previous experience in a call center is preferred
• Familiarity with medical and health insurance terminology preferred

Benefits

• Resources to live well, be healthy, continue learning, develop skills, grow professionally and serve local communities
• Remote position after training
• Required onsite components during new hire training at the Baton Rouge Corporate Campus