Customer Care Representative II | Health Plan

Avera Health Plans

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$21.75 - $29.00

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

The Customer Care Representative II is an experienced team member, knowledgeable in customer care policy and process. The Customer Care Representative II provides expertise for the department to foster and carry the customer experience strategy forward. The Customer Care Representative II will provide customer care to Avera Health Plans members, providers, groups, and Avera Health Plans staff by resolving issues accurately and timely, related to claims status and covered benefits to ensure a best-in-class customer experience.

What you will do

• Provide exceptional customer care via web solutions, in-person consultation, or phone/texting to health plan members, providers, payers, and groups. Answer questions, investigate issues, and solve complex problems by providing accurate information and solutions.
• Possess strong written communication skills via e-mail, portal, or chat. Use proper grammar, punctuation, clarity, and concise detail when using written communication skills.
• Maintains detailed documentation of all calls and issues initiated and/or addressed within the customer care department.
• Act as a point of contact in providing feedback, testing new applications, and updating tools and resources.
• Assist and mentor new and less experienced customer care representatives.
• Demonstrate in-depth knowledge of each health plan product and its benefits structures, identify ways to effectively communicate the benefits to members and providers and how those benefits were applied to claims.
• Possesses the experience and expertise necessary to support the customer care team, collaborate with other departments, and progress the strategy of the customer care department.
• Communicate Avera Health Plans policy and procedures accurately and consistently to members and providers.
• Facilitate member eligibility, entry, and termination processes for delegate vendors.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Preferred Education, License/Certification, or Work Experience:

• High School or GED Equivalent
• 1-3 years Experience in a call center environment
• Familiarity with medical terminology and medical insurance billing

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO front-loaded for eligible hires

• Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status.  If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Salary : $22 - $29