Member Services Advocate

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

📋 Description

• Act as the primary point of contact for both members and providers.

• Provide service through incoming calls and emails.

• Assist individuals in navigating their health insurance plans and clarifying their benefits.

• Address claims issues and inquiries concerning eligibility, billing, provider networks, and prescription coverage.

• Inquire to understand concerns and determine solutions or next steps.

• Clarify claims, benefits, eligibility, billing, provider networks, and prescription coverage using internal systems.

• Engage in active listening and show empathy.

• Document interactions clearly and comprehensively in the CRM system.

• Collaborate with internal departments, third-party vendors, and brokers/navigators to ensure resolution and support.

• Maintain a well-organized and dependable schedule; extended hours may be necessary during the peak season from January to March.

• Adhere to the Gravie CARE service model.

• Comply with privacy, confidentiality, security, HIPAA, and other regulatory requirements.

• Achieve or surpass performance metrics for call quality, adherence, RSAT, After Call Work, and Call Answered%.

⛳️ Requirements

• 1-2 years of experience in customer service or within a call center environment.

• A genuine desire to assist others with a proven ability to resolve complex customer issues through active listening, innovative problem-solving, and empathy.

• Strong written and verbal communication abilities.

• High dependability and commitment to maintaining a structured work schedule.

• Excellent attention to detail and organizational capabilities.

• Experience with entering and updating data in electronic systems or databases.

• Proficient in navigating computers and multitasking across various platforms and systems.

• Strong typing skills.

• Quick learner with the ability to accurately and efficiently follow established procedures.

• Results-oriented mindset with comfort in a fast-paced, dynamic environment.

• Previous experience in health insurance, healthcare, or related fields is a plus.

• Familiarity with Microsoft Office and Google Suite is an added advantage.

• An active Health Insurance Producer License or willingness to obtain licensure if necessary is a bonus.

• Experience with Medicare, Medicaid, or Marketplace plans is beneficial.

• Access to a quiet, professional workspace with reliable high-speed internet that meets organizational minimum standards.

• Must be currently authorized to work in the United States.

• Must not require employer visa sponsorship now or in the future.

🏝️ Benefits

• Coverage for alternative medicine.

• Flexible paid time off (PTO).

• Up to 16 weeks of paid parental leave.

• Paid holidays.

• 401(k) retirement plan.

• Transportation benefits.

• Education reimbursement program.

• Two days of paid paw-ternity leave.

• Standard health and wellness benefits.