Customer Care Advocate 1

Position Overview

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role.

Key Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
• Updates files, including documenting system notes of conversations or action taken.
• Performs tasks associated with the administration of retirement and health and welfare benefits including:
  • Processing and/or sending mailers or required forms as requested by members.
  • Processing and/or sending correspondence related to member or claims status.
  • Processing enrollments and updating member information in applicable system(s).
  • Distributing communications related to regulatory requirements.
• Initiates Action Requests to appropriate departments for adjustments to claims, retirement, and/or eligibility and follows up to ensure successful completion.
• Researches and resolves complex and technical issues and irregularities.
• Performs other duties as assigned.

Required Qualifications

• High school diploma or GED.
• Six months of experience in customer service, third-party administrator processing, or benefits administration.
• Strong work ethic and team player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong detail orientation and listening skills.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans, and regulations.
• Proficient computer skills including MS Office tools and applications.

Preferred Qualifications

• Call center experience in benefits claims, billing, or eligibility.

Benefits & Perks

• Health, Vision, and Dental Coverage
• 401(k) Retirement Savings Plan with company match
• Paid Time Off (PTO)
• Opportunities for professional growth
• Plus much, much more!