Provider Customer Advocate - Hybrid at Baylor Scott White Health
Temple, TX 76502, USA -
Full Time


Start Date

Immediate

Expiry Date

30 Nov, 25

Salary

0.0

Posted On

31 Aug, 25

Experience

1 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Good communication skills

Industry

Other Industry

Description
  • To be considered, please ensure you live within a reasonable commuting distance of Temple, TX
    * Interviews are underway and the targeted start date for this class is, October 6, 2025
    If selected, the onsite training hours will be from 8am to 5pm Mon through Fri, for 8 weeks in total
    ** Upon completion of training, you will work a total of 40 hours per week and your 8-hour shifts will be scheduled anytime between 7am and 5pm, Monday through Friday

ABOUT US

Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.

Our Core Values are:

  • We serve faithfully by doing what’s right with a joyful heart.
  • We never settle by constantly striving for better.
  • We are in it together by supporting one another and those we serve.
  • We make an impact by taking initiative and delivering exceptional experience.

JOB SUMMARY

The Customer Advocate 1, under general supervision, communicates to Members and Providers policy and procedures and services of the Health Plan (Plan), and handles any complaints concerning the Plan by the membership. This position works on the Members’ behalf to resolve any issues and concerns by going the extra mile, when needed.

QUALIFICATIONS

  • EDUCATION - H.S. Diploma/GED Equivalent
  • EXPERIENCE - 1 Year of Experience
Responsibilities
  • Under general supervision, communicates to Members and Providers policies, procedures and services of the Plan to ensure complete knowledge of the Plan. Helps Members with access to the Plan system, and helps members pick an appropriate physician, and help with appointments.
  • Must adhere to call handling goals of 80% of calls answered within 30 seconds. Helps and adheres to call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements. Within 60 days of employment on the floor, must meet monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored. Helps and meets schedule adherence goals based on department policy successful completion of proficiency testing following initial Advocate training.
  • Serves as a primary contact for benefits, claims status and simple drug inquiries for Personal Plans with working knowledge of other products, based on first contact resolution guidelines. Verifies demographic information on all inquiries and updates the Plan system.
  • Helps Members with concerns and effectively works toward a resolution before the concern escalates to a complaint.
  • Accesses appropriate sources to obtain benefit information requested by Member and Providers.
  • Acts as liaison between Members, Providers and billing offices, with follow through to resolve issues.
  • Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.
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