Customer Experience Advocate I

Summary

Join Wellmark as a Customer Experience Advocate (CXA) and make a difference in people's lives by providing exceptional customer service in the health insurance industry. You will handle member, provider, and stakeholder inquiries via phone, offering accurate, prompt, and professional responses. This role initially requires 12 weeks of on-site training in Des Moines, Cedar Rapids, or Sioux Falls, after which remote work options are available. The work is challenging but rewarding, with opportunities for career advancement and exceptional employee benefits. Wellmark offers a supportive and inclusive work environment that values employee well-being. Apply your compassion and empathy to help navigate health insurance needs and make healthcare better.

Requirements

• 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.)

Responsibilities

• Provide accurate, prompt, courteous, and professional responses to member, provider or other stakeholder inquiries over the phone
• 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
• 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
• 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
• 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
• Responsible for the analysis and appropriate resolution(s) of claim-related inquiries and processing
• 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
• Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs
• 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
• Engaged and participate in team meetings, chat, corporate meetings, etc
• Promptly follow up on all inquiries and document resolutions
• Responsible for the accurate recording and documentation in Wellmark’s system
• 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
• Other duties as assigned

Preferred Qualifications

• 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

Benefits

• An opportunity to work remote, upon meeting performance expectations
• A workplace that values health with access to a fitness facility, health programs, education, and services
• An opportunity for career advancement
• 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!)