Member Care Advocate

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

📋 Description

• Oversee a significant volume of daily inbound and outbound communications via phone calls and emails with members, clients, pharmacies, and healthcare providers.

• Resolve claim processing issues and inquiries directly within the claims adjudication system while maintaining a professional and engaging phone demeanor.

• Swiftly address inquiries received through the website.

• Achieve proficiency in all facets of the claims adjudication system.

• Relay recurring issues and systemic challenges to the manager.

• Address inquiries from members and clients.

• Assist members in understanding and navigating their prescription benefits.

• Tackle complex issues within the claims system effectively.

• Provide administrative assistance to Member Care leadership, Client Success, and Executive teams.

• Deliver exceptional care and service to all callers.

⛳️ Requirements

• Previous experience as a Pharmacy Technician is highly desired.

• Must have the ability to comfortably and consistently engage on the phone for the majority of the workday.

• Demonstrated experience in customer service, preferably within a call center or pharmacy environment.

• Familiarity with prescription claims processing is extremely beneficial.

• Strong analytical skills and meticulous attention to detail.

• Outstanding communication and customer relations abilities.

• Excellent problem-solving capabilities.

• Competence in multi-tasking and prioritizing tasks in a dynamic, fast-paced environment.

• Proficient in computer applications, including Microsoft Office (Excel, Word, PowerPoint, Outlook).

• Applicants must reside in the Mountain Time Zone.

• A High School Diploma and/or a college degree in a relevant field is preferred.

🏝️ Benefits

• A diverse selection of health insurance plans, including medical, dental, and vision coverage.

• Competitive salary and bonus opportunities.

• A comprehensive 401k plan with company matching contributions.

• Employee stock ownership through the ESOP, providing annual shares of stock allocation.

• Access to an Employee Assistance Program.

• Wellness initiatives offering financial incentives, chiropractic and massage services, as well as fitness stipends.

• Participation in the Dream Manager Program.

• A supportive, family-oriented workplace culture.

• Opportunities for charitable contributions and volunteer work.

• Celebratory events throughout the year.