Customer Care Advocate
CurrentESSENTIAL DUTIES AND RESPONSIBILITIES • Demonstrate the ability to drive for results and challenge the status quo• Demonstrate the drive for results and competence in problem solving, logical reasoning, analysis and mathematical functions• Demonstrate the ability to listen and understand the member situation to assess potential solutions, take needed action, and manage necessary follow up• Demonstrate the ability to manage multiple priorities, maintain organization initiatives, and stay current on tasks and responsibilities• Utilize problem solving skills, business product knowledge, and required research to accurately analyze issues, determine appropriate action, and follow up on a timely basis • Proactively seek opportunities to advocate on behalf of the member by collaborating with team members, sharing information/research, and resolving member issues • Thoroughly assess each unique member situation to provide accurate and relevant information • Understand and interpret plan documents, summary plan descriptions, plan rules and procedures• Advance first call resolution by taking ownership of the call through resolution • Provide support for member/sponsors who need assistance accessing our external website/portals • Meet or exceed the performance standards through quality monitoring, documentation and follow through process to ensure excellent service• Utilize technology systems and knowledge base to determine benefits eligibility, calculate member benefits and maintain account data on members and dependents• Manage cases to resolve in a professional and timely manner • Takes responsibility for learning system changes• Understand and apply Portico’s Performance Excellence (e.g. compliance, enterprise risk management and quality) activity standards, including entity-level policy and practice standards that pertain to control evidence retention