Member Benefits Advocate
New
T
The OccuNet CompanyHealthcare Benefits
United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 2+ years of customer service experience in member services, health care, or in a customer service or call center environment required; 1+ years of experience directly interpreting and explaining medical, dental, and/or vision plan benefits required.
- Required Skills
- Customer service
Requirements
- High school diploma or equivalent.
- 2+ years of customer service experience in member services, health care, or call center environment.
- 1+ years of experience directly interpreting and explaining medical, dental, or vision plan benefits.
- Strong understanding of benefit interpretation including coverage, eligibility, and plan limitations.
- Ability to maintain a private, distraction-free workspace for remote work.
- Reliable high-speed internet connection.
- Strong interpersonal, communication, and problem-solving abilities.
- High level of patience and professionalism when handling sensitive situations.
- Ability to work effectively in a team-first environment.
- Detail-oriented with a commitment to task completion and accuracy.
Responsibilities
- Uphold best-in-class member experiences by owning the end-to-end resolution process.
- Provide empathic support to members while remaining conscious of their unique situations and needs.
- Guide members through employer-sponsored healthcare plans by quoting benefits and interpreting plan documents.
- Verify eligibility and answer status/pricing inquiries for healthcare providers.
- Resolve payment-related inquiries on behalf of members.
- Collaborate with Account Management and Contracting teams to improve member-facing processes.
- Maintain compliance with HIPAA and Department of Labor guidelines.
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