Job details

Provider Customer Advocate - Hybrid

• To be considered, please ensure you live within a reasonable commuting distance of Temple, TX• Interviews are underway and the targeted start date for this class is, February 10, 2025• If selected, the onsite training hours will be from 8am to 5pm Mon through Fri, for 8 weeks in total• Upon completion of training, you will work a total of 40 hours per week and your 8-hour shifts will be scheduled anytime between 7am and 5pm, Monday through FridayJob SummaryThe Customer Advocate 1, under general supervision, communicates to Members and Providers policy and procedures and services of the Health Plan (Plan), and handles any complaints concerning the Plan by the membership. This position works on the Members behalf to resolve any issues and concerns by going the extra mile, when needed.Essential Functions Of The Role• Under general supervision, communicates to Members and Providers policies, procedures and services of the Plan to ensure complete knowledge of the Plan. Helps Members with access to the Plan system, and helps members pick an appropriate physician, and help with appointments.• Must adhere to call handling goals of 80% of calls answered within 30 seconds. Helps and adheres to call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements. Within 60 days of employment on the floor, must meet monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored. Helps and meets schedule adherence goals based on department policy successful completion of proficiency testing following initial Advocate training.• Serves as a primary contact for benefits, claims status and simple drug inquires for Personal Plans with working knowledge of other products, based on first contact resolution guidelines. Verifies demographic information on all inquiries and updates the Plan system.• Helps Members with concerns and effectively works toward a resolution before the concern escalates to a complaint.• Accesses appropriate sources to obtain benefit information requested by Member and Providers.• Acts as liaison between Members, Providers and billing offices, with follow through to resolve issues.• Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.KEY SUCCESS FACTORS• Requires successful completion of proficiency testing following initial Advocate training.• Must successfully complete Customer Service training and successfully pass proficiency exam to maintain CSA position.• Must successfully complete spelling, grammar and basic computer skills testing during job interview.• Must be proficient in typing and basic computer skills.• Perform well in a fast-paced, stressful routine work environment.• Must have good phone etiquette and uses effective communication skills (both verbal and written).• Must be familiar with policies, procedures and new products offered by Marketing and completes training as required.• Must be able to multi-task.• Must be knowledgeable in public relations with a diverse customer base.• Must be able to problem solve and act as advocate for the customer.BenefitsOur competitive benefits package includes the following• Immediate eligibility for health and welfare benefits• 401(k) savings plan with dollar-for-dollar match up to 5%• Tuition Reimbursement• PTO accrual beginning Day 1Note: Benefits may vary based on position type and/or levelQualifications• EDUCATION - H.S. Diploma/GED Equivalent• EXPERIENCE - 1 Year of Experience

Baylor Scott & White Health Glassdoor Company Review

3.8

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CEO of Baylor Scott & White Health

Pete McCanna

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What You Should Know About Provider Customer Advocate - Hybrid, Baylor Scott & White Health

Join the team at our Belton, TX location as a Provider Customer Advocate! In this hybrid role, you'll serve as a vital point of contact for our Members and Providers, helping them navigate the intricacies of our health plan. You’ll be vital in communicating important policies, procedures, and services, ensuring everyone is informed and guided through any inquiries they may have. If you're someone who enjoys going the extra mile for others and is committed to resolving issues before they escalate, we want you on our team! Once you're selected, you’ll participate in an intensive training program lasting eight weeks, during which you'll learn everything you need to know to excel. Your expertise will help Members find the right physicians, schedule appointments, and provide valuable information about their benefits and claims status. You’ll be part of a supportive environment where continuous improvement is encouraged, communication is key, and success is celebrated. Our schedule offers flexibility within standard business hours, and we make it a priority to meet regulatory requirements concerning call handling and quality assurance. We also provide competitive benefits, including immediate health benefits, a matching 401(k) plan, and tuition reimbursement to help you grow both personally and professionally. Come be the advocate our Members need and make a real difference in their healthcare experience!

Frequently Asked Questions (FAQs) for Provider Customer Advocate - Hybrid Role at Baylor Scott & White Health

What are the responsibilities of a Provider Customer Advocate at the health plan?

As a Provider Customer Advocate at our health plan, your key responsibilities include communicating policies, procedures, and services, handling Member inquiries and complaints, verifying demographic information, and serving as the primary contact for benefits and claims status. You'll work diligently to resolve concerns and maintain high-quality service standards.