Member Care Advocate (MCA) - November Cohort
Core
Provide empathetic, member-centered support by answering inbound calls and chats to help individuals navigate healthcare benefits, find providers, and resolve coverage issues.
Role type
Member Care Advocate (Customer Support Specialist)
Builds
Member confidence and successful navigation of healthcare benefits and care options
Domain
Healthcare / Insurance / Customer Support
Deliverable
client delivery
Required skills
Inbound call handling, benefits coverage explanation, cost-sharing concepts, in-network provider lookup, account information updates, program enrollment guidance, workflow navigation, documentation, critical thinking, de-escalation
Preferred skills
Familiarity with VoIP systems, Google Workspace, Apple products, CRM software
Technologies
CXOne, Google Workspace, Apple products, CRM software, carrier portals
Responsibilities
Answer inbound calls and chats to explain benefits and resolve member issues; Navigate systems to find providers and update account information; Guide members through program enrollment and scheduling; Document interactions accurately for continuity of care; Meet quality audit and member satisfaction expectations.
Seniority
Individual Contributor, entry-to-mid level