Customer Service Advocate - Work at home

Member Services Advocate
Our colleagues are deeply committed to giving back to the communities where they live and work, and we're looking for team members who want to be part of something biggeran organization that values compassion, collaboration, and impact. Under the general direction of the Service Center Supervisor, the Member Services Advocate provides exceptional customer service, navigating the complexities of the healthcare system, dressing inquiries, resolving issues and ensuring members have a positive experience with Point 32 Health. The Member Service Advocate is a member champion to resolve issues internally with a wide variety of departments and interacting externally with providers, employers, brokers and provider billing offices to assist with issue resolution. A candidate should be proficient in working in multiple systems at once while doing real-time analysis of data and documentation to resolve member inquiries. Training Hours: 8:30 AM 5:00 PM EST, M - F. Must have 100% attendance during training. Working as a Member Advocate provides you with hands-on experience to grow your career with Point32Health. With demonstrated initiative and strong performance, you will gain exposure across a multitude of functions providing you with opportunities for advancement. A Member Services Advocate can grow not only within the department but also throughout Point32Health.
Inbound Call Management- Handle inbound calls from members with professionalism and attentiveness, addressing inquiries related to health insurance benefits, coverage, claims and eligibility.
Health Care System Navigation- support and advocate for members to ensure that they receive the care/support needed
Member Engagement- Assist members in understanding and accessing theit benefits and educate members on how to use self service tools, deliver proactive/anticpatory service
Documentation and Reporting- Record call details and member interactions in the system accurately, ensuring that all relevant information is documented for future reference and reporting ensuring HIPPA, State and Federal regulations and confidentiality standards are met.
Member Experience- As a brand ambassador for Point32Health, go above and beyond to ensure member satisfaction, proactively identifying and addressing needs and concerns.
Continuous Improvement- Represent the voice of the customer by contributing to continuous improvement initiatives and providing feedback on member interactions and suggesting process enhancements.
Metrics & Goals- Adhere to assigned schedules to ensure appropriate phone queue coverage & meet or exceed department established key performance indicators
Compliance and Policy Adherence- Ensure all interactions are HIPAA compliant and adhere to state and federal regulations
Associate degree or equivalent work experience
Bachelor's degree or equivalent work experience preferred.
Customer Service Expertise- Demonstrated ability to provide exceptional service, including active listening, empathy, and clear communication with members.
Product Knowledge- Strong understanding of health insurance products, policies, and industry regulations, or the ability to quickly learn and apply new information.
Attention to Detail- High level of accuracy in handling member information, processing requests, and documenting interactions.
Technical Proficiency- Comfortable using computer systems, CRM software, and other relevant technology to manage member interactions and data.
Conflict Resolution- Skilled in managing and resolving conflicts and complaints with professionalism and patience.
lifting, travel):

Must be able to work under normal office conditions and work from home as required.
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
May be required to work additional hours beyond standard work schedule.
the skills, education, training, credentials, and experience of the candidate; as well as internal equity. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.
Medical, dental and vision coverage
Retirement plans
Employer-paid life and disability insurance with additional buy-up coverage options
Full suite of benefits to support career development, individual & family health, and financial health
All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact View email address on click.appcast.io.