Member Care Advocate

Medix Healthcare:

Member Care Advocate

REMOTE! (Review Strict Qualifications Before Applying)

$18-$19/HR

Anticipated Start Date: May 5th

MUST HAVE QUALIFICATIONS:=

• 5 Years Of Relevant Healthcare Experience OR Less & Bachelor's Degree

• Can Accruately describe, deductible, EOBs, Out Of Pocket Cost

• Understanding The Difference Between HSA/FSA/HRA

• Healthcare Call Center Experience, Comfortable In A Metric Driven Environment

• Insurance/Claims Background highly preferred

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
• 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 Included Health's required systems to navigate and document member interactions effectively
• Represent the mission: Clearly articulate Included Health's 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

Selling Points

• Opportunity To Work For A Large Healthcare Organization

• Full Benefits

• Contract With Potential For Permanent Hire

• Remote With Equipment Provided

3-5 Must Have Skills/Qualifications

• 5 Years Of Relevant Healthcare Experience OR Less & Bachelor's Degree

• Can Accruately describe, deductible, EOBs, Out Of Pocket Cost

• Understanding The Difference Between HSA/FSA/HRA

• Healthcare Call Center Experience, Comfortable In A Metric Driven Environment

• Insurance/Claims Background highly preferred

Nice to Have Skills

• Passionate about healthcare
• Shows empathy on the call
• Quick communication, completes assessments in a timely manner
• Knows Insurance backwards and forwards
• Can work under stress

Schedule/Shift:

Training 8 Weeks: Monday-Friday 7AM-4PM PST

After Training:

Schedules Vary from 5AM-12PM Starts (8 Hours) Open 7 Days/WK

Pay:

$18-$19/HR

#MedixWest

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.