Member Advocacy Team Specialist I

Healthcare Management Administrators-posted 14 days ago
$24 - $28/Yr
Full-time • Entry Level
Remote • Washington, DC
101-250 employees
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A Member Advocacy Team Specialist is primarily the first point of contact on the Helpline and actively works both less complicated and more complicated calls, escalations and cases. This individual is responsible for providing superior internal and external customer care support, coaching, and directing Customer Care Advocates on call handling best practices to ensure timely resolution to keep Customer Care Advocates on the phones and is delivered in a caring and professional manner consistent with the Member Advocacy Team standards. Additionally, this position provides support related to Helpline calls that require further research or that are more complex in nature, triaging, acknowledging, and assigning Member Advocacy Team emails and CRM Tasks, processing Protected Health Information (PHI), Confidential Communication, Coordination of Benefits (COB) outreach, and other duties as assigned. This individual maybe asked to provide support to the Employer/Broker Team as well as take member and provider calls when needed. The Member Advocacy Team Specialist II is also responsible for proactively participating in identifying training opportunities, system tools that Customer Care Advocates may need, and trends that drive higher Helpline calls. This individual will actively communicate training opportunities and trends to the Customer Care Management team.

  • Adhere to established Service Level Agreements for the Helpline and all new and ongoing open work items.
  • Provides superior frontline internal and external support to Customer Care Advocates and Care Management staff.
  • Advocates for Customer Care Advocates by proactively engaging with other Member Advocacy Team members to handle requests that involve additional research and resolution and will ensure issues are completed efficiently and expeditiously.
  • Models the right behaviors to positively guide and influence Customer Care Advocates and Care Management staff.
  • Work closely with the management team to stay updated on service knowledge and stay informed of any changes in department/company policies.
  • Share recommendations to the Continuous Process Improvement (CPI) team to strengthen the process for preventive measures.
  • Part of “Flexforce” team and is cross-trained/cross-utilized with Employer/Broker Support Team and Member Advocacy Team’s Escalation Team.
  • Advocate for callers by working with internal and external stakeholder to efficiently and expeditiously resolve inquiries, own it, and drive resolution.
  • Hold others accountable and report on root cause, corrective, and preventative actions to Customer Care Manager.
  • Analyze the request for clarity and engage with submitter for any follow-up information needed to assist in complete resolution of work item.
  • Own the follow-up process to ensure all elements of the work item are addressed.
  • Partner with other support team(s) when needed for resolution.
  • Provide a complete written resolution to submitter addressing all concerns and steps taken to provide resolution.
  • Work closely with other MAT team members as well as HMA management teams to triage problem-resolution, identify root cause analysis, including corrective and preventative action in order to identify and mitigate risk. Report findings to Manager and greater business as required.
  • Other duties as assigned.
  • High school diploma or equivalent
  • 1-3+ years, providing superior customer service in a call center environment
  • Excellent verbal and written communications exemplified through professional, timely, and detailed correspondence
  • Works independently with minimal supervision while maintaining a team-oriented and collaborative approach to problem solving
  • Ability to quickly adjust priorities to respond to pressing demands-and do so with a smile
  • Strong problem solving, project management, business analysis, presentation, and analytical skills
  • Strong interpersonal and communication skills, both written and verbal; comfortable and effective in communicating across all levels of the organization
  • Strong attention to detail and ability to multi-task in a complex, fast-paced environment
  • Previous experience working in a medical or healthcare field is preferred
  • Knowledge of medical terminology is preferred
  • Seventeen (IC) days paid time off (individual contributors)
  • Eleven paid holidays
  • Two paid personal and one paid volunteer day
  • Company-subsidized medical, dental, vision, and prescription insurance
  • Company-paid disability, life, and AD&D insurances
  • Voluntary insurances
  • HSA and FSA pre-tax programs
  • 401(k)-retirement plan with company match
  • Annual $500 wellness incentive and a $600 wellness reimbursement
  • Remote work and continuing education reimbursements
  • Discount program
  • Parental leave
  • Up to $1,000 annual charitable giving match
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