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Benefits Operations - CW Account Advisor I

Mindlance

Baton Rouge, LA

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JOB DETAILS
SKILLS
Billing, Brokerage, Call Centers, Call Volume, Communication Skills, Conflict Resolution, Content Management Systems (CMS), Corporate Policies, Customer Experience, Customer Satisfaction, Customer Support/Service, Data Quality, Detail Oriented, Health Insurance, Healthcare, High School Diploma, Insurance, Legal, Maintain Compliance, Marketing, Medical Assistance, Medical Billing, Medical Coding, Medical Office, Metrics, Microsoft Office, Multitasking, Network Administration/Management, Organizational Skills, Performance Metrics, Pharmacy, Presentation/Verbal Skills, Problem Solving Skills, Provider Relations, Quality Metrics, Reconciliation, Regulations, Regulatory Compliance, Regulatory Requirements, Resolve Customer Issues, Sales, Social Security Administration, Writing Skills
LOCATION
Baton Rouge, LA
POSTED
2 days ago
Job Profile – CW Account Advisor I
• High-volume call center role supporting members/providers
• Focus on benefits & claims resolution, accuracy, and customer satisfaction
• Requires strong communication, problem-solving, and healthcare knowledge
• Entry-level with 1 year experience or equivalent training
• Performance-driven environment with defined metrics
Position Summary
The Account Advisor I is responsible for resolving benefit and claims inquiries from members and providers via telephone and other approved channels within a call center environment. This role supports a positive customer experience while ensuring compliance with all applicable laws, regulations, and company policies.
Nature & Scope
• Individual contributor role; no direct reports
• Reports to: Supervisor, Customer Service
• Operates in a high-volume call center environment, with the majority of time spent on the phone
Key Contacts:
• Internal: Enrollment & Billing, Claims, Provider Relations, Benefit Operations, Network Administration, Sales/Marketing, Accounting, Medical Management, Pharmacy, Legal
• External: Members, Providers, Brokers, Employers/Groups, Other Insurance Plans, CMS, Social Security Administration ________________________________________
Core Responsibilities
• Handle inbound inquiries related to benefits, claims, billing, and eligibility
• Research and resolve customer issues across multiple systems to ensure accuracy of benefits and payments
• Responding to inquiries regarding adjustments, refunds, and payment discrepancies
• Maintain up-to-date knowledge of policies, procedures, and regulatory requirements
• Document interactions and ensure completeness and accuracy of information
• Meet established customer service performance metrics (quality, productivity, customer satisfaction, attendance)
• Demonstrate ownership of issues and drive First Call Resolution (FCR)
• Perform other duties as assigned within scope
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Minimum Qualifications
Education
• High School Diploma or Equivalent Preferred Experience
• 1 year of customer service or medical office experience required
• OR completion of BRCC Medical Assistant, Coding & Insurance pathway in lieu of experience
• Call center experience preferred
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Key Skills & Competencies
• Strong verbal and written communication skills with professionalism and empathy
• Ability to interpret and explain benefits, claims, and policies clearly
• Critical thinking and problem-solving skills
• Ability to multitask and manage multiple inquiries in a fast-paced environment
• Attention to detail and organizational skills
• Conflict resolution and ability to remain calm under pressure
• Active listening and effective questioning skills
• Proficiency in Microsoft Office and related systems
• Familiarity with healthcare/insurance terminology preferred ________________________________________
Work Environment Expectations
• Approximately 95% of time spent on phone in a call center environment
• May be required to work during emergencies or inclement weather
• Must successfully complete customer service training and demonstrate proficiency

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

About the Company

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Mindlance

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