Customer Care Advocate IA - Buffalo

Job Overview

The Customer Care Advocate resolves customer inquiries via telephone, walk‑in, mail, fax, web chat, off‑phone work, and e‑mail concerning contract benefits, claim payments, and enrollment in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements. This role enhances member and provider satisfaction and retention. The B version requires fluent Spanish.

• Provide professional, efficient, timely service to customers and business partners.
• Exercise tact, patience, and professionalism in all interactions.
• Document, research, interpret, and respond to inquiries per MTM, NCQA, HIPAA, NYSDOH, CMS, and other legislative requirements.
• Utilize appropriate resources to resolve inquiries accurately and efficiently, achieving acceptable quality and first contact resolution.
• Conduct outreach related to claims, onboarding, effectuation, retention, provider inquiries, and complex inquiries.
• Adapt and remain flexible to business changes while owning issue identification and resolution.
• Participate in meetings, training, and skill development.
• Maintain knowledge of company products and services; provide suggestions for improvements.
• Respect member privacy in accordance with corporate privacy policies.
• Maintain reliable attendance and perform additional functions as assigned.

• LevelI

  High School diploma or equivalent; customer service experience preferred. Entry level position performed under close supervision; requires attendance of all required training.

• BVersion

  Bi‑lingual English/Spanish required; fluent in Spanish. Ability to multi‑task, actively listen, navigate screens, type documentation, and speak simultaneously. Excellent computer skills in Windows; adept at working across multiple programs.

• LevelII

  In addition to LevelI requirements: rating “Performing” or above on the Agent Dashboard & competencies for at least 9 of 12 months; completed all scheduling unit training; efficient resolution of complex/? escalated issues; advanced system navigation; expanded communication across channels; minimal supervision required.

• LevelIII

  In addition to LevelII requirements: rating “Performing” or above for at least 10 of 12 months; self‑sufficient in complex issue resolution; provide mentoring; recognize opportunities; advanced problem‑solving skills.

• Traditional office environment with fluorescent lighting.
• Arrive on time; meet performance metrics.
• Work seated at a desk viewing a computer for ≥3 hours; use keyboard and mouse.
• Travel across the enterprise as required.
• Regularly required to talk and hear.

• GradeN2:
  Minimum $18.22 – Maximum $23.89 per hour.
• Other components: group health and/or dental insurance, retirement plan, wellness program, paid time off, and paid holidays.
• Remote work possibility on a case‑by‑case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.