Customer Care Advocate

Zenith American Solutions•San Francisco, CA

About The Position

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. The role has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) as required by the job description and role. The advocate maintains current knowledge of assigned plans and applies that knowledge while responding to and documenting telephone and written inquiries. The role also supports the administration of retirement and health and welfare benefits, updates member records, initiates and follows up on requests for adjustments, and researches and resolves complex or technical issues. This position involves prolonged periods of sitting at a desk and working on a computer, and may require lifting up to 15 pounds. Zenith American Solutions offers a compensation rate of $25.75 per hour and describes a benefits package that includes health, vision, and dental coverage, a 401(k) plan with company match, paid time off, and opportunities for growth.

Requirements

High school diploma or GED.
Six months of experience working in customer service, third-party administrator processing, or benefits administration.
Strong work ethic and team player mentality.
Highly developed sense of integrity and commitment to customer satisfaction.
Ability to communicate clearly and professionally, verbally and in writing.
Solid organization skills, strong attention to detail, and listening skills.
Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans, and regulations.
Proficient computer skills, including MS Office tools and applications.

Nice To Haves

Call center experience in benefits claims, billing, or eligibility.
Bilingual.

Responsibilities

Maintain current knowledge of assigned plans and apply it effectively in job functions.
Provide written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with plan benefits.
Update files, including documenting system notes about conversations or actions taken.
Process and/or send mailers or required forms requested by members.
Process and/or send correspondence related to member or claims status.
Process enrollments and update member information in applicable systems.
Distribute communications related to regulatory requirements.
Initiate Action Requests to appropriate departments for necessary claims, retirement, and/or eligibility adjustments, and follow up to ensure completion.
Research and resolve complex and technical issues and irregularities.
Perform other duties as assigned.