Job Description

Job Description

Responsibilities

Care Advocates - a dedicated team of health care professionals who compassionately and quickly advocate for our member's care. We go the extra mile, provide an understanding of benefits, schedule the appointment, navigate bills, and arrange the ride. Why? Because we care.

What you'll do:

* Work directly with members, medical providers, and internal partners to advocate for our member's care. For this role, that means receiving member calls or emails to assist in coverage and benefit questions, claims processing and appointment scheduling and when you don't have the answer, finding it.

* Contribute to department operating goals by taking initiative on behalf of our members including striving for single contact resolution, advancement of skills and training, and collaborating with the care advocate team.

* Rely on a foundation of medical and health care knowledge to meet our member's needs with empathy and efficiency.

* Provide constructive feedback and coaching to care advocates through audits and one on one meetings.

* Deescalate member or provider cases as needed by Care Advocates.

* Observe, collect and report upon trends on the floor from members and providers to close training, content and operational gaps.

* Cultivate interdepartmental relationships through transparent and honest communication with a commitment to share goals and collaboration.

* Be fully proficient in all lines of business.

Qualifications

* A strong foundation of customer service skills including empathy, active listening, resourcefulness in problem solving and team work.

* Technical proficiency as it relates to software navigation, attention to detail, web-based program organization, and a clear understanding of office program.

* Strong communication skills both written and verbal, including the ability to deescalate situations between members, medical providers, and internal partners.

* Flexibility to meet the changing demands of the business which may include night and weekend work.

* The appetite for growth, learning and working in a fast-paced, challenging environment.

* A demonstrable organization methodology that drives performance and accountability.

* Minimum High school Diploma with a preference of associates degree or higher.

* An understanding of medical and health care terms and processes.

* Ability to provide constructive feedback to fellow care advocates in an empathetic and understanding manner.

* An understanding of interdepartmental processes in order to provide quality assistance to care advocates, members, medical providers, and internal partners.

* An unwavering positivity and compassion for our members.