Client Advocate - Hybrid (Irvine, CA)

OneDigital•Irvine, CA

2d•$69,000 - $75,000•Hybrid

About The Position

Employee Benefits is the core of our business and at our heart we are a people-focused organization. Every day, we help over 100,000 employers give their employees peace of mind by providing health, pharmacy, long and short-term disability, vision, dental and other insurance solutions. What makes us unique is that we can surround our clients with more services and more technology-based tools and a team of advisors that simply cares more than anyone else. If you want a career giving people the reassurance that they can have access to the health care they need for themselves and their loved ones, join OneDigital. Our Newest Opportunity: The Client Advocate serves as a trusted, confidential resource for employees of our client organizations, providing expert guidance and hands-on support as they navigate the complexities of health insurance and healthcare access. This role is the primary point of contact for employees seeking help with benefit questions, claims issues, access to care, and insurance-related challenges. Client Advocates combine empathy and patience with persistence and problem-solving skills. They advocate firmly on behalf of employees with insurance carriers, provider offices, and third parties—while maintaining professionalism, accuracy, and strict confidentiality always.

Requirements

Exceptional verbal and written communication skills
High level of patience, empathy, and emotional intelligence
Ability to manage sensitive and confidential situations with professionalism
Strong problem-solving and critical-thinking skills
Confidence and persistence when working with insurance carriers and provider offices
Excellent organizational skills and ability to manage a high volume of cases
Detail-oriented with strong follow-through
Ability to work effectively in a fast-paced, client-focused environment
Proficiency with Microsoft Office and standard case management or CRM tools
Active Health Insurance (Life & Health) license required (or ability to obtain within 90 days of hire)

Nice To Haves

Bachelor’s degree preferred (or equivalent relevant experience)
Prior experience in one or more of the following environments strongly preferred:
Insurance carriers
Employee benefits brokerage or consulting firms
Physician or hospital offices
Medical billing or revenue cycle departments
Healthcare administration or patient advocacy roles

Responsibilities

Serve as the primary point of contact for employees via phone and email for benefit questions and issue resolution
Explain benefit plans, eligibility, enrollment timing, and cost-sharing in clear, accessible terms
Support employees during open enrollment by helping them understand options and make informed plan selections
Assist with locating in-network providers and care resources
Triage and support urgent eligibility issues impacting access to care or prescription coverage
Coordinate with carriers, vendors, and internal teams to resolve eligibility discrepancies and restore coverage when needed
Investigate and resolve medical, dental, vision, and pharmacy claims issues
Support referrals, prior authorizations, and transition-of-care needs
Work directly with carriers, provider offices, and billing departments to resolve complex cases
Manage escalations and appeals, including Department of Insurance submissions when required
Partner with Account Management and Consulting teams on priority cases and recurring advocacy themes
Provide advocacy stewardship reporting, including case volume, outcomes, trends, and key escalations
Advocate persistently and professionally with carriers and providers on behalf of employees
Maintain accurate case documentation and timely follow-through
Uphold strict HIPAA compliance and handle sensitive situations with empathy and discretion