Member Services Advocate

Primary responsibilities for this position include providing prompt and excellent service for our members and providers through inbound calls and emails. Calls will be focused around all things health insurance as it relates to how a member leverages and utilizes their insurance plan. Examples could be, but not limited to: provider and prescription inquiries, benefits, claims, eligibility and billing.

· Go above and beyond to provide the member or provider with a simple and seamless experience.

· Courteously respond to member and provider inquiries via inbound call or email.

· Determine the best way to resolve member and provider inquiries by asking probing questions and making appropriate recommendations based on health insurance product path and program.

· Correctly communicate claims and benefits information using designated internal platform(s) to further assist with caller's inquiries.

· Demonstrate empathy and active listening in each interaction with the caller.

· Accurately document all interactions within our Customer Relationship Management (CRM) platform with clarity and professionalism.

· Collaborate with additional third-party entities, navigators/brokers, and internal departments to assist with caller's needs.

· Be able and willing to maintain a highly structured work schedule. Overtime hours, including early morning, evening or weekend time may be required during peak season January - March.

· Demonstrate commitment to CARE (Compassion, Advocacy, Resolution, Education) service model and the company-wide core competencies of being authentic, curious, creative and outcome-oriented.

· A passion for helping people and demonstrated success solving complex issues for customers using active listening, creative problem solving and empathy

· Strong written and verbal communication skills and ability to summarize information effectively

· Excellent reliability and ability to adhere to a structured schedule

· Strong attention to detail and organizational skills

· Experience entering/updating data in electronic systems

· Proficient computer navigation, including toggling between multiple systems and platform, as well as typing skills

· Ability to be self-driven and work effectively with many types of individuals

· Ability to learn quickly and consistently follow a process, through accurately and in a timely manner

· Proven ability to get results and thrive in an ever-evolving environment

· Previous health insurance experience

· Prior customer service or call center experience

· Familiarity with Microsoft Office, Google Suite

· Willingness to obtain producer licensure as needed or Active Health Insurance Producer license a plus

· Complete 6 weeks of in-person paid training provided by the company

· Commit to a set weekly schedule of 40 hours per week between the hours of 7am and 7pm Central Time

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