Member Care Advocate
New
J
JobgetherHealthcare
Based in United States, 10 a.m. to 7 p.m. ESTContractMiddle
Salary not disclosed
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Job Details
- Languages
- English
- Experience
- 2 years of customer service or healthcare experience, or 5 years of relevant healthcare or benefits navigation experience.
- Required Skills
- Customer serviceGoogle WorkspaceCritical thinkingCRM
Requirements
- Bachelor’s degree with at least 2 years of customer service or healthcare experience, or 5 years of relevant healthcare or benefits navigation experience.
- Experience managing a high volume of inbound calls using phone or VoIP systems.
- Strong understanding of customer service principles and the ability to advocate for members in challenging situations.
- Excellent verbal communication skills.
- Strong written communication skills in English.
- Ability to learn and navigate CRM platforms, healthcare systems, Google Workspace, Apple products, and proprietary tools.
- Strong critical-thinking skills.
- Ability to manage sensitive information while maintaining confidentiality and HIPAA compliance.
- Reliable internet connection and ability to work from a secure, distraction-free home office.
- Strong self-management skills and ability to succeed in a remote work environment.
- Availability to complete a required 3-week paid training program from 10 a.m. to 7 p.m. EST, Monday through Friday, without planned time off.
Responsibilities
- Handle inbound member calls and chats with professionalism, empathy, and clear communication.
- Help members understand healthcare benefits, including coverage details, deductibles, copays, coinsurance, out-of-pocket limits, and eligibility information.
- Assist members with locating in-network providers, updating account details, and receiving status updates on existing requests.
- Guide members through available healthcare programs, virtual care services, enrollment processes, and scheduling steps.
- Resolve member questions from start to finish by following established workflows and providing clear education.
- Use internal systems, knowledge bases, and external portals to research information and identify appropriate solutions.
- Maintain accurate documentation of member interactions, actions taken, and follow-up requirements.
- Escalate complex situations appropriately while providing clear summaries to support additional team assistance.
- Maintain high-quality service standards by meeting performance expectations related to accuracy, member satisfaction, and communication quality.
- Protect member privacy and maintain confidentiality in accordance with HIPAA requirements.
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