FEP QUALITY SERVICE ADVOCATE

Job Summary:
The role of a Service Advocate is focused on servicing current FEP Members. The major accountability of this role is scheduling HEDIS preventive care appointments with members primary care provider or assisting member to obtain a primary care provider. In addition, the accountability of this role is to provide customer (Member) satisfaction.

Essential Functions:

• The essential functions listed represent the major duties of this role, additional duties may be assigned.
• Conduct telephonic outreach guided by scripts, to members for introducing the HEDIS campaigns and initiatives and benefits of Clinical Care Programs. The goal is to Assist Members to obtain preventive screenings needed to close a specific HEDIS care gap and schedule appointment with the Care Management clinician to discuss the programs for possible enrollment and/or assist with obtaining a primary care provider.
• Must possess excellent communication skills (written, verbal and listening).
• Use computerized systems for tracking, information gathering and troubleshooting.
• Actively seek, identify and implement process improvement opportunities.
• Documents telephonic outreach in required system: JIVA
• Provides soft transfer to customer service as needed
• Adhere to call flows

Required Work Experience:

• 3+ years related work experience or equivalent combination of transferable experience and education.

Experience Details:

• Related experience in a medical and/or insurance setting
• Strong oral and written communication skills and ability to effectively communicate. (written, verbal and listening)
• Must be able to talk and document simultaneously (good computer skills)
• Knowledgeable on Microsoft word/Excel programs
• Ability to deliver a positive customer experience.

Additional Preferred Qualifications:

• Customer service experience in a healthcare call center

No supervisory/management experience required
High School diploma or GED Required