Resp & Qualifications
PURPOSE:
Responsible for answering member, provider & broker inquiries pertaining to product information, benefits, claims resolution, eligibility and billing questions in a call center environment. Proactively provides information and education to members, providers & brokers, as appropriate, about a variety of health, financial, and self-service programs. Provides basic technical assistance and troubleshooting guidance for digital and electronic applications.
ESSENTIAL FUNCTIONS:
- Provides first- level problem resolution to member, provider & broker inquiries via telephone by gathering and researching information; examine claim submissions verifying claim and system accuracy as well as liability, validate customer understanding of information and resolves issues based on applicable policies and procedures.
- Uses knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret contractual language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer all types of services to customers within the business segment through telephonic inquiries, written and/or electronic inquiries and claims adjustments, if applicable. Appropriately documents all client interactions according to established departmental procedures.
- Delivers accurate information to customers in accordance with performance goals and objectives.
- Maintains customer records by updating account information by effectively utilizing the business areas enrollment/inquiry tracking system & processes.
Participates in ongoing education related to new services, industry topics, and skills
QUALIFICATIONS:
Education Level: High School Diploma or GED.
Experience: Less than one year customer service experience.
Preferred Qualifications
Less than 1 year experience in a call center customer service role or experience with medical or insurance terminology.
Knowledge, Skills and Abilities (KSAs)
- Successful completion of the training provided.
- Demonstrated skills as an empathetic and compassionate communicator.
- Ability to quickly gain customer trust and confidence.
- Demonstrated PC navigation and data entry skills.
- Strong interpersonal communication skills.
- Good oral and written communication skills.
Salary Range: $32,256 - $59,136
Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location.
In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship.
About the Customer Service Advocate I - MD Medicaid (Remote) Opportunity
CareFirst BlueCross BlueShield is currently hiring for a Customer Service Advocate I - MD Medicaid (Remote) position based in Baltimore, MD, US. This is a contractor opportunity suited to candidates who are ready to contribute their skills and grow within a dynamic team environment. Whether you're an experienced professional or looking to take the next step in your career, this role offers a chance to work on meaningful projects while developing new capabilities.
What the Role Involves
As a Customer Service Advocate I - MD Medicaid (Remote), you will be expected to collaborate closely with cross-functional teams, take ownership of key deliverables, and contribute ideas that help CareFirst BlueCross BlueShield achieve its goals. Day-to-day responsibilities typically include planning and prioritizing tasks, communicating progress with stakeholders, maintaining high standards of quality, and adapting to evolving business needs. The exact scope of duties may vary depending on team structure and current priorities, so candidates should be comfortable with a role that can evolve over time.
Who CareFirst BlueCross BlueShield is Looking For
Successful candidates generally bring a combination of relevant experience, strong communication skills, and a proactive attitude toward problem-solving. CareFirst BlueCross BlueShield values individuals who can work independently as well as part of a team, who are detail-oriented, and who bring a positive, adaptable mindset to their work. Prior experience in a similar Customer Service Advocate I - MD Medicaid (Remote) capacity is beneficial, though a strong willingness to learn and grow is equally important.
This position sits within the financial_services space, so familiarity with the trends, tools, and standards common to that industry can be an advantage, though it is not always a strict requirement.
Compensation and Benefits
This role offers a compensation package of approximately USD 2688 - 4928 per month, commensurate with experience. In addition to base pay, many roles at CareFirst BlueCross BlueShield may include benefits such as health coverage, paid time off, opportunities for professional development, and a supportive work culture designed to help employees thrive both personally and professionally.
Why Join CareFirst BlueCross BlueShield?
Joining CareFirst BlueCross BlueShield as a Customer Service Advocate I - MD Medicaid (Remote) means becoming part of a team that values collaboration, innovation, and continuous improvement. Employees are encouraged to bring their own perspective to the table, and the organization aims to foster an environment where people feel supported in doing their best work. This is a great opportunity for candidates who want their contributions to have a real, visible impact.
How to Apply
If you believe you're a strong fit for the Customer Service Advocate I - MD Medicaid (Remote) role at CareFirst BlueCross BlueShield in Baltimore, MD, US, we encourage you to review the full job details above and submit your application through the listed channel. This position was posted on 2026-06-10 and applications are being accepted through 2026-08-09. Early applications are generally encouraged, as competitive roles like this one can attract a high volume of interest.
