You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

As a Member Advocate, you’ll act as a trusted guide, helping members navigate the complexities of their healthcare benefits while delivering high-quality support. Member 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, our client wants to hear from you.

Key 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 resolving health plan-related questions, claims, 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 by taking full ownership of member issues from start to finish, researching and resolving complex cases.
• Empower members through education, helping them understand their available benefits and guide them in accessing services that meet their needs.
• Leverage internal and external resources to determine the best course of action, ensuring accurate and actionable information is provided.
• Utilize tools and technology to navigate and document member interactions effectively.
• Represent the mission and fully understand the scope of services to deliver consistent, high-quality advocacy.
• Drive member satisfaction by ensuring all interactions meet quality standards, focusing on delivering empathetic, efficient, and member-focused service.

Qualifications

• Bachelor’s degree or 5 years of relevant experience in healthcare (preferred).
• Comfort with high-volume inbound phone work and familiarity with VoIP phone systems (e.g., CXOne).
• Technical proficiency: Strong familiarity with Google apps, Apple products, and customer relationship management software, with ability to adapt to proprietary tools quickly.
• Exceptional customer service skills, with the ability to act as a member advocate and prioritize their needs.
• Strong verbal communication skills: Confidently explain services, maintain a professional and friendly phone demeanor, and handle challenging conversations effectively.
• Strong written communication skills: Ability to communicate with members and providers in writing, demonstrating strong business writing skills in English.
• Critical thinking and problem-solving: Ability to think critically and use resources to solve complex situations.
• Understanding of confidentiality and compliance, particularly HIPAA guidelines and regulations.
• Ability to work remotely from a secure home office, free from distractions, with the discipline to succeed in a remote environment.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*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 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.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.