The Wellness Advocate is responsible for managing client service requests for Preferred Accounts. They also design, communicate and execute Wellness Plan in coordination with their assigned clients. They serve as a liaison between the Company its clients and vendors, assisting with customer service support and wellness advocacy to preferred accounts, or as assigned by their supervisor.
RESPONSIBILITIES:
- Expedite the resolution of client’s issues regarding benefits, coverage, eligibility and pre-authorizations, pre-certifications and reimbursement requests.
- Designs and Presents Wellness Annual Plans to the appropriate management team of assigned clients for approval.
- Provide electronic copy of meeting minutes to clients within 24 hours of a meeting.
- In coordination with insurance company resources and client’s internal resources plans, communicates and supports health fairs, clinics, employee talks and other wellness related events included in the wellness plan.
- Coordinates resources for the clinics, health fairs, information tables and employee orientations. This includes the process of inviting and confirming resources in advance, as well as re-confirming resources and materials 24 hours prior to each event.
- Submits wellness events promotional communications two weeks prior to any event for client approval and follows up with final versions, at least one week prior to the event.
- Provides follow ups to clients regarding wellness events to ensure; materials are ready and available, clients knows which resources will attend, and that client meets minimum requirements (such as number or participants or type of facilities) for a particular clinic or event.
- Handle service requests from Clients (tickets) within two (2) hours (for all requests received prior to 3:00pm) or during the first two (2) hours of the next day for requests received (after 3:00pm) the prior afternoon.
- Communicate and document results of service requests to clients through the SysAid tool provided, as well as by telephone to clients in case of urgent eligibility or pharmacy issues.
- Maintain a ticket resolution rate of 91% of SLAs during regular season and 85% during Open Enrollment.
- Create and submit wellness communications as assigned by supervisor.
- Print customers communications, pack supplies for client events (including open enrollment sessions) and print/bind presentations as assigned by supervisor.
- Performs other duties as assigned by supervisor.
