Member Advocate

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Address inbound member inquiries through telephone and email regarding provider access, plan benefits, claims, and balance billing issues.

• Perform outbound outreach to providers to verify plan acceptance and collect necessary information.

• Assist in resolving balance billing matters and ensure member access to care.

• Inform members, providers, employers, brokers, and internal partners about plan design, coverage, tools, and resources.

• Gather, assess, and document details related to provider access challenges and balance billing issues.

• Coordinate necessary signed HIPAA authorizations when needed.

• Act as a liaison among members, providers, and internal teams.

• Record interactions, actions taken, and outcomes in the relevant systems.

• Achieve productivity, quality, and customer service performance goals.

• Partner with Client Service team members and leadership on projects, ad hoc reporting, and process assistance.

• Elevate complex access or resolution matters to leadership.

• Carry out additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is required.

• 1 to 2 years of customer service experience is necessary.

• 1 to 2 years of experience in employee health and benefit plan administration is preferred.

• Strong verbal and written communication skills.

• Excellent interpersonal and customer service abilities.

• Proficient in Microsoft Office Suite or similar software.

• Exceptional time management skills with a demonstrated ability to meet deadlines.

• Strong analytical and problem-solving capabilities.

• Ability to thrive in a fast-paced and occasionally stressful environment.

• Internet connection through a cable broadband or fiber optic internet service provider.

• Minimum internet speeds of 100Mbps download and 25Mbps upload are required.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Life insurance.

• Disability insurance.

• Generous paid time off.

• Tuition reimbursement.

• Employee Assistance Program (EAP).

• Technology stipend.

• Fully remote work.

• Flexible work-from-home arrangement.