Member Care Advocate
New
I
Included HealthHealthcare
Remote, 10 a.m. - 7 p.m. ESTContractEntry
Salary not disclosed
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Job Details
- Languages
- English
- Experience
- Bachelor's degree with a minimum of 2 years of customer service or healthcare experience, OR 5 years of relevant experience in healthcare or benefits navigation.
- Required Skills
- DocumentationCustomer serviceGoogle WorkspaceCRM
Requirements
- Bachelor's degree with a minimum of 2 years of customer service or healthcare experience, or 5 years of relevant experience in healthcare or benefits navigation.
- Comfortable handling a high volume of inbound calls using VoIP phone systems (e.g., CXOne).
- Strong familiarity with Google Workspace, Apple products, and customer relationship management (CRM) software.
- Ability to learn proprietary tools quickly.
- Exceptional customer service skills with the ability to de-escalate challenging situations.
- Strong verbal communication skills to explain benefits and processes clearly.
- Strong written communication skills in English for accurate documentation.
- Demonstrated critical thinking ability to work within defined workflows.
- Must understand and follow HIPAA guidelines and maintain member confidentiality.
- Ability to work from a secure, distraction-free home office with reliable internet.
- Must be able to complete the 3-week paid training period (10 a.m. - 7 p.m. EST Monday - Friday) with no planned time off.
Responsibilities
- Answer inbound calls and chats respectfully and empathetically, using clear, plain language to help members feel confident and informed.
- Explain benefits coverage, cost-sharing concepts, and basic eligibility details.
- Find and confirm in-network providers, update account information, and provide status updates on requests.
- Connect members to available programs by guiding them through enrollment or scheduling steps.
- Resolve member questions using established workflows and educate members to reduce future confusion.
- Navigate company systems, knowledge bases, and carrier portals to research questions and identify next steps.
- Document interactions and follow-up actions in systems to ensure continuity of care.
- Meet or exceed expectations for quality audits and member satisfaction.
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