Florida Blue, Service Advocate III, State Group Contact/Claims, Jacksonville Remote

Requirements

• Provide assistance to State members by responding to benefit and claim related inquiries via telephone and in writing.
• Utilize the Florida Blue Call Strategy to provide outstanding customer service and call resolution to our members;
• Educate and answer member questions on the access and use of member self-service tools.
• Perform research, request additional information from the provider, member and/or supporting plans if necessary, and make decisions to return, pend, pay or deny low risk claims in order to properly adjudicate claims and inquiries within contract benefit and claims processing guidelines.
• Evaluate data through questioning, probing, and reasoning for process improvements.
• Research and resolve service-related inquiries for members and providers, meeting established expectations for quality, productivity and timeliness.
• Provide customer service and education to plan members and providers by answering more complex questions regarding insurance claims and policies, resolving issues and ensuring customers understand the Company’s products, services and processes.

Benefits

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan including employer match;
• Paid time off, volunteer time off, 10 holidays and 2 well-being days;
• Additional voluntary benefits available;
• A comprehensive wellness program