Job Title: Member Care Advocate (Remote)

Requirements:
- Must have knowledge/experience with health insurance/terms
- Looking for 5+ years in a similar role, with call center and remote experience

Training: Training is 10 weeks - M-F (will be required to pass testing throughout the training period)
Monday-Friday from 7am to 4pm Pacific Time / 10a to 7pm Eastern Time

Schedule/Shift: Department is open 7 days a week. Mostly M-F schedules

Location: Remote

Time Off: No time off for the first 90 days

Duration: Contract to Hire (based on attendance/performance)

Pay: $18-19.50/hr (based on location/cost of living)

Official Job Description:

Job Summary:

As a Member Care Advocate, you'll act as a trusted guide, helping members navigate the complexities of their healthcare benefits while delivering high-quality support. Member Care Advocates are the most visible representatives of our mission to raise the standard of healthcare for everyone, everywhere. In this role, you will handle high-volume interactions and play a critical part in simplifying healthcare for members. If you're a driven, empathetic individual with a strong interest. In helping people and solving problems, we want to hear from you.

Responsibilities:

• Provide empathetic support: Answer inbound calls and chats from members, providers, and vendors, ensuring each interaction is respectful, compassionate, and solutions-oriented
• Advocate for members by taking ownership of their healthcare navigation needs , including:
• Assist members in resolving health plan-related questions, including claims and billing inquiries, prior authorizations, and benefits coverage.
• Facilitate access to virtual care services, second opinions from an expert, and other healthcare resources.

• Own the member journey: Take full ownership of member issues from start to finish, researching and resolving complex cases to minimize member effort
• Empower members through education: Help members understand their available benefits and guide them in accessing the services that best meet their needs
• Leverage internal and external resources: Research internal tools and external benefits to determine the best course of action, ensuring accurate and actionable information is provided
• Utilize tools and technology: Demonstrate proficiency with the required systems to navigate and document member interactions effectively
• Represent the mission: Clearly articulate the mission and fully understand the scope of our services to deliver consistent, high-quality advocacy
• Drive member satisfaction: Ensure all interactions meet quality standards, focusing on delivering empathetic, efficient, and member-focused service

  Key Success Metrics:

  • Availability and adherence: Maintain a consistent presence for members while adhering to an assigned schedule.
  • Quality of Interactions: Demonstrate high standards in service, performance on audits, and member satisfaction surveys.
  • Impactful Advocacy: Effectively represent member needs, connect them to valuable resources, and champion their healthcare journey.

  Qualifications:

  • Education and experience: Bachelor's degree or 5 years relevant experience in healthcare (preferred)
  • Comfort with high-volume inbound phone work: Familiarity with VoIP phone systems (e.g., CXOne) and comfortable handling a high volume of calls l throughout the entire day
  • Technical proficiency: Strong familiarity with with Google apps, Apple products, and customer relationship management software, and ability to adapt to proprietary tools quickly
  • Customer service excellence:Exceptional customer service skills, with the ability to act as a member advocate and prioritize their needs.

  
  Benefits: In order to be eligible for health benefits, you must be employed for 30 days and must average 30 hours per week over your first four weeks on assignment. If you become eligible and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).
  
  As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:
  
  401(k) Retirement Plan (After 6+ months of service, during a 401k enrollment period)
  Medical, dental and vision plans with The American Worker, as well as three Major Medical Plan options!
  Prescription Programs
  Short Term Disability Insurance
  Term Life Insurance Plan
  Compensation: Dependent upon experience
  
  Apply Today!
  #MEDIXHC

  For California Applicants:

  We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

  This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.