Customer Engagement Advocate II (Customer Service)

Customer Engagement Advocate II (Customer Service)

Lumen Solutions Group Inc. is a technology consulting Services company based in Florida. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in professional IT consulting services, IT Staffing, Business/IT Strategy, Business Process Blueprints, Enterprise Architecture, and Enterprise Transformation.

Role: Customer Engagement Advocate II (Customer Service)

Location: 100% Remote

Type: Contract-to-Hire (C2H)

Job Description: We are seeking a Customer Engagement Advocate II to provide exceptional customer service and support to members, providers, and brokers in a fast-paced healthcare call center environment. This role is responsible for handling inquiries related to benefits, claims, eligibility, billing, and healthcare products while ensuring a positive customer experience. The ideal candidate will have strong customer service skills, experience working in a high-volume call center environment, and the ability to research and resolve issues efficiently while maintaining service excellence standards.

Key Responsibilities

• Respond to inbound calls from members, providers, and brokers regarding healthcare products and services.
• Research and resolve inquiries related to: Medical Claims, Benefits, Eligibility, Billing, Coverage Questions.
• Investigate claim issues and verify claim accuracy, eligibility, and liability information.
• Explain benefit plans, coverage limitations, and healthcare programs to customers.
• Provide education regarding self-service tools, digital applications, and available healthcare resources.
• Document customer interactions accurately within internal systems.
• Deliver timely and accurate resolutions while meeting established service levels and performance metrics.
• Manage multiple systems and applications while handling customer inquiries.
• Provide basic technical support and troubleshooting assistance for online and digital platforms.
• Escalate complex issues when appropriate and follow through to resolution.

Required Qualifications

• High School Diploma or GED.
• Minimum 3 years of customer service experience.
• Experience working in a call center or high-volume customer support environment.
• Strong verbal and written communication skills.
• Excellent problem-solving and conflict-resolution abilities.
• Strong computer navigation and data entry skills.
• Ability to multitask and work effectively in a fast-paced environment.
• Strong attention to detail and organizational skills.

Preferred Qualifications

• Healthcare customer service experience.
• Medical insurance experience.
• Experience handling claims, benefits, eligibility, or billing inquiries.
• Experience supporting members, providers, or brokers.
• Familiarity with healthcare terminology and insurance concepts.

Skills & Competencies

• Customer Service Excellence
• Call Center Operations
• Claims Resolution
• Benefits & Eligibility Support
• Problem Solving
• Active Listening
• Conflict Resolution
• Data Entry & Documentation
• Multitasking
• Time Management
• Microsoft Office Suite
• Strong Communication Skills

Lumen Solutions Group Inc is an equal opportunity employer. All qualified applicants will be considered for employment without regard to any legally protected status.