Customer Care Advocate

Zenith American Solutions•Denver, CO

2d•Onsite

About The Position

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. This role has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII). Zenith American Solutions is the largest independent Third Party Administrator in the United States, operating over 44 offices nationwide, with its original entity in business since 1944. The company was formed in 2011 from a merger between Zenith Administrators and American Benefit Plan Administrators. Zenith American Solutions aims to provide better systems for better service by hiring dedicated, energetic employees who share a dedication to high-quality work, exceptional service, and mutual respect. The company fosters a positive, respectful, and supportive work environment, offering challenging opportunities and supporting a healthy work/life balance. Its culture is founded on integrity, honesty, and respect for all stakeholders, boasting a low employee turnover rate and high internal promotions, reflecting an 80-year legacy of excellence.

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, both verbally and in writing.
Solid organization skills with strong detail orientation 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

Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions.
Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
Updates files, including documenting system notes of conversations or action taken.
Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing and/or sending mailers or required forms as requested by members.
Processing and/or sending correspondence related to member or claims status.
Processing enrollments and updating member information in applicable system(s).
Distributing communications related to regulatory requirements.
Initiates Action Requests to appropriate departments requesting adjustments to claims, retirement, and/or eligibility as necessary.
Follows up to ensure successful completion of Action Request.
Researches and resolves complex and technical issues and irregularities.
Performs other duties as assigned.