Client Advocate - Hybrid; Irvine, CA

Client Advocate - Hybrid (Irvine, CA) page is loaded## Client Advocate - Hybrid (Irvine, CA) locations:
Irvine, CAtime type:
Full time posted on:
Posted Todayjob requisition :
R8230

Employee Benefits is the core of our business and at our heart we are a people-focused organization. Every day, we help over 100,000 employers give their employees peace of mind by providing health, pharmacy, long and short-term disability, vision, dental and other insurance solutions. What makes us unique is that we can surround our clients with more services and more technology-based tools and a team of advisors that simply cares more than anyone else.

If you want a career giving people the reassurance that they can have access to the health care they need for themselves and their loved ones, join One Digital.
** Our Newest Opportunity:
** The Client Advocate serves as a trusted, confidential resource for employees of our client organizations, providing expert guidance and hands-on support as they navigate the complexities of health insurance and healthcare access.

This role is the primary point of contact for employees seeking help with benefit questions, claims issues, access to care, and insurance-related challenges. Client Advocates combine empathy and patience with persistence and problem-solving skills. They advocate firmly on behalf of employees with insurance carriers, provider offices, and third parties—while maintaining professionalism, accuracy, and strict confidentiality always.
** Essential Duties and Responsibilities (include but are not limited to):
*** Employee Advocacy
* · Serve as the primary point of contact for employees via phone and email for benefit questions and issue resolution
· Explain benefit plans, eligibility, enrollment timing, and cost-sharing in clear, accessible terms
· Support employees during open enrollment by helping them understand options and make informed plan selections
· Assist with locating in-network providers and care resources
* Eligibility & Access Support
* · Triage and support urgent eligibility issues impacting access to care or prescription coverage
· Coordinate with carriers, vendors, and internal teams to resolve eligibility discrepancies and restore coverage when needed
* Claims & Issue Resolution
* · Investigate and resolve medical, dental, vision, and pharmacy claims issues
· Support referrals, prior authorizations, and transition-of-care needs
· Work directly with carriers, provider offices, and billing departments to resolve complex cases
· Manage escalations and appeals, including Department of Insurance submissions when required

Account Team Partnership & Reporting
· Partner with Account Management and Consulting teams on priority cases and recurring advocacy themes
· Provide advocacy stewardship reporting, including case volume, outcomes, trends, and key escalations

Professional Advocacy & Compliance
· Advocate persistently and professionally with carriers and providers on behalf of employees
· Maintain accurate case documentation and timely follow-through
· Uphold strict HIPAA compliance and handle sensitive situations with empathy and discretion
** Qualifications, Skills and Requirements:*
* · Exceptional verbal and written communication skills
· High level of patience, empathy, and emotional intelligence
· Ability to manage sensitive and confidential situations with professionalism
· Strong problem-solving and critical-thinking skills
· Confidence and persistence when working with insurance carriers and provider offices
· Excellent organizational skills and ability to manage a high volume of cases
· Detail-oriented with strong follow-through
· Ability to work effectively in a fast-paced, client-focused environment
· Proficiency with Microsoft Office and standard case management or CRM tools
** Education, Training and

Experience:

*
* · Bachelor’s degree preferred (or equivalent relevant experience)
· Active Health Insurance (Life & Health) license required (or ability to obtain within 90 days of hire)
· Prior experience in one or more of the following environments strongly preferred:
· Insurance carriers
· Employee benefits brokerage or consulting firms
· Physician or hospital offices
· Medical…