Customer Care Advocate

Position Summary

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. The role has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role.

• Maintain current knowledge of assigned Plan(s) and effectively apply knowledge in all job functions.
• Provide written, verbal, or face‑to‑face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
• Update files, including documenting system notes of conversations or action taken.
• Perform tasks associated with the administration of retirement and health and welfare benefits such as processing and/or sending mailers or required forms upon member request.
• Process and/or send correspondence related to member or claims status.
• Process enrollments and update member information in applicable system(s).
• Distribute communications related to regulatory requirements.
• Initiate Action Requests to appropriate departments requesting adjustments to claims, retirement, and/or eligibility as necessary.
• Follow up to ensure successful completion of Action Request.
• Research and resolve complex and technical issues and irregularities.
• Perform other duties as assigned.

• High school diploma or GED.
• Six months of experience working in customer service, third‑party administrator processing, or benefits administration.
• Strong work ethic and team‑player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong detail orientation and listening skills.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans, and regulations.
• Proficient computer skills including MS Office tools and applications.

• Call center experience in benefits claims, billing, or eligibility.
• Bilingual.

$19.00/hr.

Working Conditions/Physical Effort:
Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.

Disability Accommodation:
Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, we provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship.