[Hiring] Member Advocate-Product @Allied Benefit Systems

Role Description

The Member Advocate will be responsible for all plan member communications in the Allied Advocate Department. Advocate will work with plan members throughout the process starting with patient letter and finishing with call to explain final resolution. Communication may be in written or verbal form.

Essential Functions

• Confer with members by telephone and/or email to answer questions or provide information in response to inquiries on Allied Advocate claims.
• Contact members to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
• Coordinate with member and/or client services to obtain a signed HIPAA release to aide with the negotiation process.
• Keep records of member and provider interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.
• Obtain and examine all relevant information to assess need for negotiation on balance due issues.
• Work with other departments (Account Management, Client Services, Customer Service) as needed to resolve member issues.
• Meet and sustain productivity and quality metrics determined by management.
• Other duties as assigned.

Qualifications

• High school diploma or equivalent work experience required.
• 1-2 years of customer service experience required.
• Insurance knowledge preferred.
• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills.
• Proficient with Microsoft Office Suite or related software.
• Excellent time management skills with a proven ability to meet deadlines.
• Strong analytical and problem-solving skills.
• Ability to function well in a high-paced and at times stressful environment.

Requirements

• Accountability
• Communication
• Customer Service Orientation
• Functional/Technical Skills
• Quality Focus
• Time and Task Management

Physical Demands

This is standard desk role requiring extended periods of sitting and computer work.

Work Environment

Remote

Benefits

• Medical, Dental, Vision, Life and Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• EAP
• Technology Stipend