Member Benefits Advocate
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The OccuNet CompanyHealthcare
Amarillo, TX; Lubbock, TX; Dallas, TX; Oklahoma City, OK; Tulsa, OK; Albuquerque, NM; Denver, CO; Las Vegas, NVFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 2+ years of customer service experience; 1+ years of experience interpreting medical/dental/vision plan benefits
- Required Skills
- Customer service
Requirements
- High school diploma or equivalent.
- 2+ years of customer service experience in member services, healthcare, or a call center environment.
- 1+ years of experience directly interpreting and explaining medical, dental, and/or vision plan benefits to members and providers.
- Strong understanding of benefit interpretation, including coverage, eligibility, cost-share, plan limitations, and prior authorization.
- Ability to maintain a private, distraction-free workspace with reliable high-speed internet for remote roles.
- Team-first mindset with high motivation and drive.
- Ability to navigate sensitive situations with care, patience, and professionalism.
- Commitment to organizational missions focused on improving member healthcare experiences.
Responsibilities
- Uphold best-in-class member experiences by owning the end-to-end resolution process.
- Practice the company's outward mindset philosophy by providing empathic support to members.
- Assist members in navigating employer-sponsored healthcare plans by quoting benefits and interpreting plan documents.
- Support providers with eligibility verification, quoting benefits, and resolving payment-related inquiries.
- Proactively anticipate member needs and offer solutions to enhance their experience.
- Collaborate with Account Management and Contracting teams to streamline member-facing processes.
- Maintain compliance and confidentiality regarding HIPAA and Department of Labor guidelines.
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