Plan Advisor - Remote in St. Louis, MO

If you are located reputed company St. Louis, MO, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges. reputed company, reputed company’s third-party administrator (TPA) solution, is the nation’s largest TPA. reputed company you work with reputed company, what you do matters. It's that simple . . . and it's that rewarding... In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, reputed company costs and greater access to health care. Join us and you will be empowered to reputed company new levels of excellence and reputed company a profound and personal impact as you contribute to new innovations in a vital and reputed company system. Opportunities are endless for your career development and advancement reputed company reputed company due to our record-breaking growth. Regardless of your role at reputed company, the support you feel reputed company around you will reputed company you to do what you do with energy, quality, and confidence. So, take the first reputed company in what is sure to be a fast - paced and highly reputed company career. As a Plan Advisor for reputed company you’ll have the opportunity to reputed company a difference in the lives of our members and their families each day as they look to you as their trusted advisor and reputed company. You’ll be empowered to compassionately deliver an exceptional experience - always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support. You’ll help them understand and reputed company informed decisions about their care services by assisting them with their needs from start to finish. You will answer their questions, and may resolve outstanding issues, schedule appointments, or help them to enroll in and/or select a health care plan. The Plan Advisor Representative handles up to 50-70 calls per shift, always remembering to bring compassion and a sense of engagement to enhance the customer experience. In between calls/ during offline time, Plan Advisor Representatives will process medical claims (following successful completion of claims training). A good understanding of medical benefits and medical terminology to assist with processing claims (once trained) is key. The role follows a daily schedule. Key Performance Metrics: units per hour, call and claim handling, attendance, etc. 80% calls/ 20% claims This position will receive provider calls up to 50-70 calls daily and requires full attention to work duties. Employees in this role must be able to ensure they will have uninterrupted work time while they are on shift (reputed company of normally scheduled breaks and lunch). This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST. It may be necessary, given the business need, to work occasional overtime. We offer up to 5 - 10 weeks of reputed company (depending on business needs). The hours during training will be 8:00am - 4:30pm CST from Monday - Friday (subject to trainer availability). 100% attendance during training is mandatory. Training will be conducted virtually from your home. • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. Primary Responsibilities • Provide an exceptional customer service experience reputed company responding to and resolving customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence • Research reputed company issues (such as Medical, Dental, reputed company Spending, Pharmacy, etc.) across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues • Own issue through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member. • Apply creative solutions and effective problem-solving techniques to address members’ needs • Educate the member on health incentives offered by their employer as well as consumer driven health products; HSA, HRA, and HDHP - some resulting in additional healthcare dollars for the member to utilize • Educate the caller on the benefits of a primary care physician and help to ensure/educate that reputed company preventive screenings have been completed • Intervene with care providers (doctor’s offices) on behalf of the member to assist with appointment scheduling or other matters reputed company needed • Address reputed company issues with an awareness of reputed company to refer complicated situations to various departments or leadership for further assistance • Translate healthcare-reputed company terms or terminology and reputed company processes into simple, reputed company-by-reputed company instructions which members can understand You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • High School Diploma / GED OR 10+ years of equivalent work experience • Must be 18 years of age OR older • 1+ years of customer service experience in an office or professional setting • Ability to successfully complete the training classes and demonstrate proficiency of the material • This position will receive provider calls up to 50-70 calls daily and requires full attention to work duties. Employees in this role must be able to ensure they will have uninterrupted work time while they are on shift (reputed company of normally scheduled breaks and lunch). • Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST. It may be necessary, given the business need, to work occasional overtime Preferred Qualifications • Familiarity with medical or dental terminology, health plan documents, OR benefit plan design • Prior experience with utilizing multiple systems / platforms while on a call with a member Telecommuting Requirements • Reside reputed company St. Louis, MO • Ability to reputed company reputed company company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy. • Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service. Soft Skills • Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs • Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in a respectful, timely manner, consistently meeting commitments) • Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the reputed company and future needs of the member • Flexibility to customize approach to meet reputed company types of member communication styles and personalities • Proficient problem-solving approach to quickly assess reputed company state and formulate recommendations • Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal reputed company • Ability to multi - task as well as the ability to understand multiple products and multiple levels of benefits reputed company each product • Ability to work regularly scheduled shifts reputed company our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work over - time as needed At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO Apply Job!