Customer Care Advocate I/II/III – Excellus

Hiring Event!!

Excellus will be recruiting “live” on Monday, June 24th from 10am - 12pm at RochesterWorks! located on 255 North Goodman Street, Rochester NY 14607.

If interested, please make sure to come in and meet Excellus recruiters in person for an opportunity to be pre-screened.



The Customer Care Division (CCD) Advocate resolves customer inquiries via telephone, walk in, mail, fax, web chat and email concerning, but not limited to, contract benefits, claim payments, and enrollment in accordance with MTM, Corporate Service strategy, NCQA and legislative requirements. Incumbents exercise tact, patience, and professionalism at all times in responding to internal/external customers, regardless of the issue or the customer’s demeanor and demonstrates flexibility with scheduling to meet customer demands. Acts as a liaison among the customers, business partners, and plans in a professional, self-directed manner to ensure and promote customer satisfaction and retention.

Essential Responsibilities/Accountabilities:  

  • Researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with MTM, NCQA, HIPAA and other legislative requirements.
  • Resolves customer inquiries in an accurate, organized, efficient, and expert manner; resulting in acceptable accuracy and production levels and retention of subscriber contracts.
  • Develops skills necessary to continuously improve upon issue resolution as defined under tier 1 training.
  • Responds to customers in a professional, efficient manner to encourage public acceptance of corporate products, services, and policies.
  • Identifies patterns generated by external and internal action effecting customer satisfaction.
  • Identifies and follows through on potential issues affecting the insurance industry.
  • Participates in the training needed to learn regulations, legacy systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job.
  • Consistently adheres to all Customer Service policies, procedures, and performance measures including inquiry documentation procedures.
  • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct.
  • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
  • Regular reliable attendance is expected and required
  • Performs additional duties as assigned by Management.

Level I:

  • Entry level position
  • Duties performed under close supervision
  • Attends all training required to become proficient in position

Level II:

  • Successful completion and proven proficiency of skills as defined under tier 2 training.
  • Duties performed under limited supervision
  • Resolves customer inquiries across multiple lines of business

Level III:

  • Staff rotation on Assist Queue, and cross-trained to help Claims
  • Initiates involvement for higher level responsibilities or proactively volunteers for assisting in the resolution of escalated or systemic issues.

Minimum Qualifications:

All levels:

  • Associates degree in Business Administration, Health Care Administration, Health Economics or related or 1 year of customer service experience required; preferably in a call center environment.
  • Ability to multi-task in order to efficiently resolve customer concerns, by actively listening to the customer, navigating screens on the computer, typing call documentation, and speaking to the customer simultaneously.
  • Excellent computer skills required, including the ability to navigate in a Windows environment. Skillful at working between multiple programs and applications at the same time. Proficient at using instant messaging and text messaging technology.
  • Adept at communicating effectively and diplomatically.
  • Organizational, reasoning and problem-solving skills.
  • Strong organizational skills and ability to prioritize, multitask, and work in fast paced environment and remain professional and focused under multiple pressures and demands.
  • Ability to work effectively as a member of a team.

Level II:

In addition to Level I qualifications:

  • Minimum of 1 year of group market customer interface experience required.
  • Ability to resolve complex or escalated group market customer queries
  • Demonstrated proficiency navigating in a Windows environment.
  • Advanced skill working between multiple programs and applications simultaneously.
  • No performance management issues in the last 12 months (internals only)
  • No more than 1 instance of not meeting all quality benchmark touch point measures (internals only)
  • Rated Performing or above at Level I (internals only)

Level III:

In addition to Level II qualifications:

  • Minimum of 2 years of group market customer interface experience required.
  • Minimum 1-year experience on a rotating call queue
  • Ability to resolve customer inquiries across multiple plans (Coordination of Benefits)
  • Ability to utilize root cause analysis skills to identify potential systemic issues
  • No performance management issues in the last 12 months (internals only)
  • Meeting or exceeding all quality benchmark touch point measures (internals only)
  • Rated High Performing or above at Level II (internals only)

Physical Requirements:

  • Work is completed in a normal office environment under fluorescent lighting.
  • Ability to use a headset to listen to customer conversations required.
  • Must be able to function while sitting at a desk viewing a computer and using a keyboard and mouse for 3 or more hours at a time
  • In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.




  • Associates or better in Business Administration.
  • Associates or better in Economics.
  • Associates or better in Healthcare Administration.



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