Health Care Advocate

Job Title: Member Services Advocate

We at Convey Health Solutions focus on building specific technologies and services that can uniquely meet the needs of government-sponsored health plans. We are looking for people to help be a part of those solutions.

As a Member Services Advocate, you will be a part of a team that transforms customer service into customer care by delivering an amazing experience. You will assist beneficiaries with a wide range of critical services which include but not limited to updating account information, providing plan information and resolving issues with utilization of the plan. Qualified candidates will have a strong desire to help people, strong customer care skills, attention to detail and be very organized.

As our customers share concerns and provide us with valuable feedback, your ability to recognize and complete the steps necessary to meet their needs will leave a permanent, lasting impression of the passion you have for helping them be at their best.

We make sure our customers are not alone when it comes to understanding their benefits and they will rely on you to advocate for them as you would your own family member.

Update account information such as billing options and changes of address or phone numbers.

Research premium billing discrepancies and prescription claims processed.

Displays positive demeanor, technical accuracy and conformity to company policies.

Understands CMS Guidance and ensures applicable exhibits are being mailed per CMS Guidance.

Ensure HIPAA regulations are maintained within the immediate environment.

Responsible for maintaining a high level of call quality as set by client standards, which includes a 95% quality score and answering 80-85% of calls within 30 sec or less.

Communicate with coworkers, management and customers in a courteous/professional manner.

Conform with and abide by all regulations, policies, work procedures and instructions.

Respond promptly when returning telephone calls and replying to correspondence.

Minimum 2 years working in a fast-paced high volume call center environment, retail customer service or hospitality. Convey Health Solutions, together with Pareto Intelligence™, delivers a powerful combination of purpose-built technology, advanced analytics, and expert services to help health plans thrive in a complex, post--Affordable Care Act environment.

As a trusted partner to Medicare and commercial payers, we provide scalable, compliant solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment, Stars performance, and member engagement. Pareto's deep analytics and financial intelligence complement Convey's operational expertise, enabling our clients to improve performance, reduce costs, and create better healthcare experiences for millions of Americans--especially seniors and vulnerable populations.

Together, we help health plans scale smarter, grow stronger, and make healthcare work better for the people who need it most.