Member Experience Advocate

Position Summary

The Member Experience Advocate is responsible for delivering exceptional service and support to members, ensuring their needs are met efficiently and effectively. This role focuses on enhancing member satisfaction, resolving inquiries, and fostering positive relationships to promote loyalty and trust. You will also work closely with physicians and facilities to facilitate care focused consistently on delivering a white glove member experience. The ideal candidate will possess strong communication skills, problem-solving abilities, and a commitment to providing outstanding customer experience.

Key Responsibilities

Member Support:

• Serve as the primary point of contact for members, addressing inquiries via phone, email, chat, or other communication channels.
• Provide accurate information regarding products, services, policies, and procedures.
• Resolve member concerns promptly and professionally, escalating issues when necessary.

Relationship Building:

• Build and maintain positive relationships with members by understanding their needs and delivering personalized solutions.
• Actively listen to member feedback and identify opportunities to improve their experience.

Problem Resolution:

• Investigate and resolve member complaints or issues, ensuring timely and satisfactory outcomes.
• Collaborate with internal teams to address complex problems and implement solutions.

Process Improvement:

• Identify trends in member inquiries and recommend process improvements to enhance efficiency and satisfaction.
• Contribute to the development of best practices and training materials for member support.

Documentation and Reporting:

• Maintain accurate records of member interactions, inquiries, and resolutions using company systems.

Compliance and Standards:

• Adhere to company policies, procedures, and regulatory requirements.
• Ensure all communications align with organizational values and standards of professionalism.

Qualifications

Education and Experience:

• High school diploma or equivalent required; associate’s degree preferred.
• 2+ years of experience in customer service, member advocacy, or a related field.
• Minimum 2 years of healthcare experience.
• Minimum 2 years of experience working with third party administrator (TPA).
• Minimum 2 years of experience working with Reference Based Pricing (RBP) methodology. 
• Experience with triage- appropriate prioritization of requests based on both business and medical considerations.
• Ability to identify opportunities to streamline workflows and enhance the member experience.
• Knowledge of medical benefit plans.
• Ability to maintain a high level of integrity and confidentiality of medical information.
• Strong organizational skills.
• Strong time management skills.
• Authorized to work in the United States on a full-time basis without Company sponsorship.

Skills and Competencies:

• Exceptional verbal and written communication skills.
• Strong interpersonal skills with the ability to empathize and connect with members.
• Problem-solving and critical-thinking abilities.
• Proficiency in Microsoft 365 tools (e.g., Outlook, Teams, Excel) and CRM systems.
• Ability to multitask and prioritize in a fast-paced environment.
• Ability to maintain a high level of integrity and confidentiality of medical information.

Personal Attributes:

• Detail-oriented and organized.
• Positive attitude and a commitment to delivering excellent service.
• Strong time management skills.
• Strong organizational skills.
• Adaptable and open to feedback for continuous improvement.

Schedule

Full-time (40 hours/week).

• Day Shift: 8:00 AM – 5:00 PM ET
• Evening Shift: 11:00 AM – 8:00 PM ET

We are seeking candidates for both day and evening shifts. Please indicate your preferred shift when applying.

Salary for this position ranges from $50,000.00-$65,000.00. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

Qualifying positions will also be eligible for comprehensive benefits, such as participation in family medical and dental insurance programs, 401K plan, and PTO.