Customer Experience Advocate I

Job Description

Do you love sharing your compassion and empathy for others in the workplace? Is delivering a phenomenal customer experience important to you? If so, then it's a great time to consider growing your career with Wellmark!

About the opportunity: Our Operations division is currently seeking multiple talented, curious, and compassionate Customer Experience Advocates (CXA) that are eager to serve as trusted partners in navigating their health insurance needs. Your days will be filled with phone calls from our members, providers, and other stakeholders. Sometimes the work can be challenging and complex but will also be rewarding for those who want to make an impact by serving on the front lines to support our members. The CXA will provide accurate, prompt, courteous, and professional responses to member, provider or other stakeholder inquiries over the phone.

Aside from meaningful-challenging work, we offer:

• Minimum starting pay of $19.50/hr (Sioux Falls). In addition to base pay, this role offers a broader total compensation package including annual performance incentives, other earning opportunities, and a direct promotion track.
• An opportunity to work hybrid, upon meeting performance and system expectations
• A strong focus on optimizing the customer experience – our mission is to Make Health Care Better!
• A culture of respect, diversity, inclusion, and commitment to our community
• A culture of individuals who are curious, committed, and connected
• 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!)

Start date & training:

The start date for this training class is Monday, August 17th. This position requires that you work onsite in our Des Moines, Iowa, or Sioux Falls, South Dakota office for a minimum of 12-weeks until you are effectively meeting attendance and performance goals. This training builds every day and prepares you to be comfortable and confident as a Customer Experience Advocate. It is critical to your success that you take no time off during this training program.

Hours:

- For the first 6 weeks, the hours during training will be 8:00am - 4:30pm
- After 6 weeks, and going forward, the hours will shift to 8:30am - 5:00pm

Working Hybrid:

Once you have successfully completed onsite training and are effectively demonstrating attendance and performance expectations, you will have the flexibility to continue working onsite, every day or as hybrid, which allows you to work from home on Mondays and Fridays, and onsite Tuesday, Wednesday, Thursday each week. Please note: If you choose to work hybrid after the training, this role requires you to have your own reliable high-speed internet and a quiet, private space in your home to discreetly take calls to ensure information confidentiality. You must have access to a non-cellular, non-satellite internet service provider, and the ability to directly connect your Wellmark issued computer via ethernet cable into your modem to allow for the best connection and call quality. If you experience consistent issues with your internet provider, or your upload and download speeds are not adequate, you will be asked to work from the office. The minimum speed should be 10 mbps upload and 10mbps download. You can check your internet speed here -

• Employees working hybrid may be asked to return to the office full time for additional training, if your performance falls below expectations.

Qualifications:
Qualifications

Preferred:

• Hands-on experience using AI tools, including effective interaction (prompting), applying human oversight, and validating outputs to ensure accurate, customer-ready information.
• Demonstrated experience working within specified time constraints, such as a structured schedule with adherence goals, etc.
• Prior experience and/or knowledge in health insurance or related industry.

Required:

• High School Diploma or GED.
• A minimum of 1 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.).

Additional Information

a. Responsible for delivering an excellent customer experience for member, provider and other stakeholder inquiries via telephone in a contact center environment, while adhering to a structured schedule and meeting quality, attendance and production standards. Strives to provide first call resolution and de-escalates calls, as necessary.

b. 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.

c. 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.

d. 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.

e. 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.

f. Responsible for the analysis and appropriate resolution(s) of claim-related inquiries and processing. Will 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.

g. Develop and maintain a strong business acumen within Wellmark market segments/lines of business and group benefit designs.

h. 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.

i. Engaged and participate in team meetings, chat, corporate meetings, etc.

j. Promptly follow up on all inquiries and document resolutions. Responsible for the accurate recording and documentation in Wellmark’s system. Will 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.

k. Other duties as assigned.

_ _ An Equal Opportunity Employer __

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us View email address on click.appcast.io

Please inform us if you meet the definition of a "Covered DoD official".

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment-Based Immigrants

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.