Healthcare Benefits Advocate
As a Healthcare Benefits Advocate, you will serve as a trusted resource for employees and health plan members, providing guidance, education, and support as they make important healthcare and enrollment decisions.
In this role, you'll assist customers through inbound and scheduled outbound phone interactions, helping them understand their healthcare benefits, compare plan options, and make informed decisions based on their unique needs and financial situations.
Success in this position requires strong healthcare benefits knowledge, exceptional communication skills, empathy, and a commitment to delivering an outstanding customer experience.
What You'll Do
- Answer inbound customer calls and conduct scheduled outbound appointments.
- Educate customers on healthcare plan options and benefit programs.
- Explain key healthcare concepts, including:
- Premiums
- Deductibles
- Coinsurance
- Copays
- Out-of-pocket costs
- Help customers evaluate the financial impact of available benefit options.
- Guide customers through enrollment and benefits selection processes.
- Create, update, and process benefit elections within company systems.
- Accurately document customer interactions and case details, maintaining detailed notes and follow-up information in case management tools.
- Participate in ongoing healthcare and benefits training programs.
- Apply coaching and feedback to continuously improve performance.
- Meet established quality, productivity, and service-level goals.
What We're Looking For
Education and Experience
- 3+ years of experience working with health plan benefits, healthcare enrollment, or benefits administration.
- Degree in a healthcare related field a plus, but not required.
Required Knowledge and Skills
- Knowledge of healthcare benefits and insurance plans, including:
- PPO plans
- High-Deductible Health Plans (HDHPs)
- Health Savings Accounts (HSAs)
- Health Reimbursement Arrangements (HRAs)
- Understanding of medical, prescription, dental, vision, and behavioral health benefits.
- Familiarity with Medicare Parts A, B, C, and D.
- Knowledge of COBRA benefits administration.
- Experience reviewing medical claims, billing, and healthcare coverage information.
- Strong customer service and problem-solving skills.
- Excellent verbal and written communication abilities.
- Strong attention to detail and organizational skills.
- Ability to work independently while collaborating within a team environment.
- Comfort navigating multiple computer applications and systems simultaneously.
Preferred Qualities
- Compassionate and empathetic approach to customer interactions.
- Ability to explain complex healthcare information in simple, easy-to-understand terms.
- Adaptability in a fast-paced, evolving environment.
- Strong critical thinking and decision-making skills.
- Commitment to professionalism and customer advocacy.
Work Environment
- Remote work using a personal computer that meets company requirements.
- Extended periods of computer and phone use – this is a high volume client and the majority of your day would be spent on the phone.
- Participation in virtual video meetings and training sessions.
- Flexibility to work varying schedules and occasional overtime based on business needs. Core schedule is 9:00 AM – 5:30 PM EST, however overtime may be needed up until 7:00 PM EST if there are appointments remaining at the end of the day.
Technical Requirements:
Because this is a remote position, candidates should have:
- A quiet, distraction-free workspace in a non-shared space. This cannot be in a public office, or a room where other people will be present during working hours.
You will need to provide your own equipment for this role that meets the requirements outlined below.
- Desktop or Laptop Computer (Tablets, Chromebooks, WinBooks, Macs, or Virtual Machines etc are not permitted)
- Processor: i5 or newer (or Ryzen 5+) 2GHZ processing power or better
- Minimum 16GB RAM
- 256 GB SSD
- You must have administrator access on the computer you are using.
- Windows 11 OS, fully up to date.
- A reputable Antivirus software.
- High Speed Internet Access with 20MBPS Download and 20MBPS Upload or better
- You are unable to use a wireless internet connection for this position, you must be hardwired with a hardline cable or DSL connection
- VPN's are not permitted while on the clock
- Dual Monitors, at least 20 inch.
- Wired USB headset Plantronics Model 3310 or 3320
- Webcam for meetings and training
- All peripherals must be hardwired for use (keyboard, mouse, etc.)
Pay: $20.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Work Location: Remote
