Customer Care Advocate 1

About the Role

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. This role has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) as required by the job description.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies this knowledge in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
• Updates files, including documenting system notes of conversations or actions taken.
• Processes and/or sends mailers, required forms, and correspondence related to member or claims status.
• Processes enrollments and updates member information in applicable system(s).
• Distributes communications related to regulatory requirements.
• Initiates Action Requests to appropriate departments for adjustments to claims, retirement, and/or eligibility as necessary, and follows up to ensure completion.
• Researches and resolves complex and technical issues and irregularities.
• Performs other duties as assigned.

Qualifications

• High school diploma or GED.
• Six months of experience 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.

Preferred Qualifications

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

Compensation

$29.68/hr

About Zenith American Solutions

Zenith American Solutions is the largest independent Third Party Administrator in the United States, operating over 44 offices nationwide. Formed in 2011 from the merger of Zenith Administrators and American Benefit Plan Administrators, we combine resources, best practices, and scale to deliver better systems for better service. We believe in hiring the best employees to achieve our goals and offer a comprehensive benefits package, including health, vision, and dental coverage, a 401(k) plan with company match, paid time off (PTO), and opportunities for growth.

Disability Accommodation

Zenith American Solutions provides reasonable accommodation for qualified applicants or employees with disabilities, in compliance with the Americans with Disabilities Act (ADA) and applicable federal and state laws. For accommodation requests, contact the Recruiting Department at recruiting@zenith-american.com.