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Customer Service Advocate II

3 months ago

Houston, United States Deans Professional Services Full time
Job DescriptionJob Description

Dean’s Professional Services is now hiring for a qualified,Customer Service Advocate IIto work in the greaterHoustonarea for a large Healthcare Organization.


The Customer Service Advocate IIis primarily responsible for, but not limited to responding to incoming hotline inquiries as they relate to benefits and eligibility verification, claim status (with the ability to identify if a claim requires reconsideration), authorization status, and complaints, accurate documentation recording of all calls; effective follow-up of calls, as required; and proper electronic routing with effective documentation skills while maintaining confidentiality per HIPAA guidelines.


Job Responsibilities:

  • Ability to respond effectively and timely to inbound calls regarding benefits and eligibility, claims to process status, and authorization status. For those calls pertaining to claims inquiry, the Customer Service Advocate will effectively handle questions and document transactions in the proper claim modules, provide first call resolution, when possible, by identifying problems and providing solutions, submitting adjustment reconsideration requests when appropriate, and identify and track trends and report them to the appropriate manager for resolution.
  • Maintains a working knowledge of the claim systems and accurately enters the required information into the designated Customer Relationship Management system (CRM), while adhering to departmental and organizational policies and procedures.
  • Maintains a professional behavior and exhibit excellent interpersonal skills
  • Ensures all interactions are conducive to developing and maintaining a cooperative and productive working environment (both internally and externally).
  • Maintains self-control and conducts activities in non-adversarial manner.
  • Actively contributes to achievement of departmental goals, as identified in Department’s annual business plan, including specific departmental process improvement plans.
  • Demonstrates core values, including trust, integrity, mutual respect, diversity, responsiveness, and caring service.
  • The ability to be flexible in an ambiguous and dynamic environment.
  • A service orientation and a “can do” attitude.
  • The ability to receive feedback and apply it to work performance.
  • Consistently demonstrates strong ethics and sound judgment.


Job Requirements:

  • Must have High School diploma or general education degree (GED).
  • 1 year healthcare insurance, managed care, or related experience.
  • Cross-functionality in Claims and Authorization Status, Benefits and Eligibility for at least two (2) lines of business for all Customer calls and/or electronic communication.

  • Must have a High School diploma or general education degree (GED).

  • One year of customer service experience in a call center or in a face-to-face setting.

    • Ability to work independently under minimal direction.

    • Moderate to advanced computer knowledge is required.

    • MUST be Fully vaccinated


Job Details:

  • Schedule: Monday – Friday 8:00 AM – 5:00 PM (Must be flexible)

  • $17.00 HR

  • Temp–to–Hire Opportunity


Dean’s Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 45,000 professionals across the nation. We work with our clients to provide placement opportunities that match your skill, experience, and personality. For more information, please visitwww.deansprofessionalservices.com.