Independent Member Advocate - Hybrid (Medfield, MA)

Location: Medfield Junction

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:

Summary:

As an Independent Member Advocate, you will be the first point of contact for our clients’ employees providing concierge service support via phone and emails.

Your role is to ensure a positive member experience by addressing benefit inquiries, educating members on available resources and resolving claims/service provider billing issues efficiently.

Essential Duties and Responsibilities (include but are not limited to):

Manage high volume of incoming calls and emails explaining healthcare plan benefits, assisting members with locating in-network physicians/facilities, educating members on available self-help resources maintaining 90% or above in answered calls.

Outbound calls to provide eligibility/benefit information to healthcare service providers, advocating for member with health care provider, pharmacy, insurance carrier to resolve problems quickly and efficiently.

Respond to basic inquiries on Flex Spending Accounts/Commuter Benefits, ancillary benefits, COBRA and Medicare Troubleshoot debit card declines and online portal access

Identify eligibility or claims errors, and collaborate with other departments for correction to ensure a seamless member experience

Review book of business prior to renewal to revise client/member contact sheets and renewal materials to include Benefits Guide, benefit summaries, medical funding sheets in conjunction with built plans

Verify eligibility and benefits for healthcare providers and inquiries regarding claim payments and remittances.

Document call and email interactions according to standard procedure

Respond to incoming email inquiries efficiently and timely with follow-ups according to standard procedure

Escalate complex issues to higher-level representatives when necessary

Build and retain relationships with plan members and clients

Maintain 3 or above on CSAT Phone surveys

Qualifications, Skills and Requirements:

High school diploma or equivalent.

Basic customer service skills with a friendly, professional demeanor

Strong communication and interpersonal skills.

Willingness to learn and adapt to new processes

Ability to thrive in a fast-paced environment

Reliability, punctuality, and the ability to manage time efficiently while handling multiple duties at once Education, Training and

Experience:

6 months to 2 Years of customer service experience in group benefits: 2 years is preferred

Knowledge of healthcare benefits and the ability to communicate information to members

Proficient in Microsoft Outlook, Word, Excel and PowerPoint;

The typical base pay range for this role nationwide is $28 to $32 per hour.

Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company’s performance. We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs.

You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts.

To learn more, visit:  is an equal opportunity employer. Not only as a matter of standard, but to honor and celebrate our differences. We believe that the power of ONE starts with you. We are committed to cultivating and preserving a culture that celebrates diversity, insists on equity and inclusion, and connects us. Ensuring our people…