Account Advisor I - Provider Services (remote - la/hybrid Training) - Remote Eligible

Call Center Class Account Advisor

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Residency in or relocation to Louisiana is preferred for all positions. Grade 3.

Are you searching for your next career opportunity? Do you have a passion for providing excellent customer service? Would like to work from home? We are actively recruiting for a Call Center Class beginning in October 2025! Apply today and join us in supporting our mission to improve the health and lives of Louisianans.

What does an Account Advisor do?

Serve as the first point of contact for the organization. The Account Advisor handles incoming calls from members and providers answering questions and offers guidance via the telephone with individuals in a prompt, courteous, and professional manner.

What is a must have?

• Customer Service experience or equivalent
• Must be available to report to the Baton Rouge Corporate Campus for the onsite components of new hire training.
• Commitment to training program
• Hardwired internet connection with speeds greater than 5MB upload and 10MB download

What's in it for you?

• A comprehensive new hire training program designed to help set you up for success
• Competitive pay
• Excellent benefits package including medical, dental, vision, life insurance, an amazing Wellness Program, 401k contributions in addition to paid time off, and paid holidays
• Professional development opportunities and access to grow your career
• Volunteer Opportunities
• Employee Resource Groups (ERGs) to share and connect with your coworkers

Position Purpose

Resolves benefit and claims inquiries received via the telephone, in person, or other acceptable receipt method from our members or providers in the call center. Promotes and maintains a positive company image through direct contact with customers. Complies with all laws and regulations associated with duties and responsibilities.

Nature and Scope

• This role does not manage people
• This role reports to this job: SUPERVISOR, CUSTOMER SERVICE
• Necessary Contacts: Enrollment & Billing, Claims, Provider Relations, Benefit Operations, Network Administration, Sales/Marketing, Accounting, Medical Management, Pharmacy, and Legal departments as well as members, providers, groups, brokers, other plans, insurance companies, Social Security Administration and Centers for Medicare and Medicaid Services (CMS).

Qualifications Education

• High School Diploma or equivalent preferred

Work Experience

• Prior experience as listed below required:
• 1 year of customer service or medical office experience required
• Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the one year of experience.
• A certificate in medical office assistant or medical coding can be used in lieu of the one year of experience
• Previous experience in a call center is preferred

Skills and Abilities

• Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook, etc.) and related software as other corporate software programs and applications.
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
• Familiarity with medical and health insurance terminology preferred
• Conflict resolution skills and remains calm under pressure/stressful situations
• Must be able to to demonstrate critical thinking and problem solving skills
• Demonstrate attention to detail
• The ability to actively listen and ask appropriate questions, to effectively understand issues that are presented from customers.
• Reading comprehension skills are required due to the high amount of direct customer contacts and the need to understand customer contract benefits and training materials.
• Effective organizational and interpersonal skills are required. Must have the ability to multi-task and handle work independently as well as organize and prioritize multiple customer issues.
• Ability to take ownership of issues from the beginning, seeking First Call Resolution (FCR)
• Must be able to verbally communicate on the telephone in a call center environment approximately 95% of the time in the Customer Care Center.
• Employees may be expected to work during inclement weather or other emergency situations when needed.
• Must have ability to successfully complete Customer Service training, with demonstrated proficiency in training materials.

Licenses and Certifications

• None Required

Accountabilities and Essential Functions

• Reviews and researches billing and healthcare claim inquiries from members and providers, to ensure proper benefits and/or payments are applied correctly; researches multiple computer systems/applications to verify data/information accuracy.
• Responds to inquiries regarding adjustments, refunds, edits and/or payment registers to ensure completeness, accuracy and customer satisfaction to members or providers.
• Maintains knowledge of required lines of business, changes to applicable company policies/procedures, recent laws and regulations, and related computer systems to ensure information is current and accurate when providing service to members or providers on the telephone in the call center.
• Meet Customer Service performance goals/expectations in the areas of efficiency, accuracy, quality, production, customer satisfaction, and attendance
• The ability to verbally communicate on the telephone approximately 95% of the time.
• Account Advisor Is who work on the Medicare LOB must be able to follow CMS (Center for Medicare and Medicaid) standards including but not limited to: following a defined process for handling Medicare Grievances, identify differences between an inquiry, grievance, & appeal, and meet specific schedule requirements (may have to work nights, weekends and/or holidays).

Additional Accountabilities and Essential Functions

• Perform other job-related duties as assigned, within your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.