What are the responsibilities and job description for the Account Servicing Advocate II position at Hawaii Medical Service Association?
Employment Type
Exempt or Non-Exempt
Job Summary
Pay Range: $42,000 - $78,000
Note: Individuals typically begin between the minimum to middle of the pay range
To provide Best Customer Experience, Most Affordable Care, and Best Quality Care, by assisting with the daily operations of the unit to resolve enrollment, eligibility and billing issues and inquiries from members and employer groups accurately and timely. Ensure that all government, association and department guidelines, objectives and performance standards are met. Perform audits and recommend methods of improving customer satisfaction and processing efficiency. Lead activities and participate in unit project as assigned.
Minimum Qualifications
- Bachelor's degree or four years related experience or equivalent combination of education and experience.
- Effective verbal and written communication skills.
- Requires attention to detail and the ability to work on multiple projects simultaneously.
- Working knowledge of general office practices and procedures.
- Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
Duties and Responsibilities
- Monitor calls in queue and unresolved group or member enrollment, eligibility and billing issues and inquiries. Handle and resolve elevated irate/complaint calls. Direct and regulate the resolution of routine issues and inquiries in order to meet deadlines, reassigning lower-level representatives' work based on assessments of intake flow and the representatives' individual capacities. Audit phone calls and email conversations to identify patterns, including proactively analyzing and evaluating systemic root problems. Take corrective action to address any identified problems/issues, including coaching peers or recommending improvement opportunities to management. Assist with training new team members into the unit.
- Lead activities to implement business rules or system enhancements and facilitate changes or improvements needed to correct problems and improve servicing for the unit. This includes conducting analysis, workflow or procedural testing and updating associated documentation. Lead the requirements definition, testing and implementation of unit projects as assigned.
- Resolve complex eligibility discrepancies due to differences between a member / group bill and the member's / group's payments. Resolve data discrepancies and other problems to maintain the integrity of the member records.
- Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by:
- Researching and collaborating with other units or departments to find a solution
- Accurately updating member records
- Contacting external partners who provide services to HMSA's members
- Providing member or group education on enrollment, billing (bill presentment) and bill payment
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
Salary : $42,000 - $78,000
