Posted 3 months ago
Member Services Advocate
AI Summary
Member Services Advocates at HealthCheck360 independently guide members through complex healthcare and benefits issues, resolve escalated claims and billing disputes, and coordinate with providers and carriers to achieve timely outcomes.
About this role
Member Services Advocate
Member Services Advocates play a critical role in delivering advanced advocacy services, serving as a trusted resource for members navigating complex healthcare and employer benefit situations. This role is intended for experienced professionals with a strong background in health insurance, claims resolution, or benefits administration who can independently assess issues, interpret plan details, and drive outcomes across multiple stakeholders.
In this role, you will guide individuals through complex coverage scenarios, resolve escalated claims and billing issues, and partner directly with providers, carriers, and third-party administrators to ensure accurate and timely resolution. This position requires a high degree of ownership, critical thinking, and the ability to manage sensitive or multi-layered issues with minimal oversight.
We are seeking candidates who bring proven, hands-on experience navigating health plans and claims processes, including direct interaction with providers or carriers. Successful candidates will be confident advocating on behalf of members in complex situations and comfortable managing issues that require coordination across multiple parties. This role is best suited for individuals with experience in health insurance, TPAs, provider offices, or benefits administration who are ready to apply their expertise in a highly specialized, member-facing advocacy role.
Full-Time Benefits - Most benefits start day 1
- Medical, Dental, Vision Insurance
- Flex Spending or HSA
- 401(k) with company match
- Profit-Sharing/Defined Contribution (1-year waiting period)
- PTO/Paid Holidays
- Company-paid ST and LT Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
About HealthCheck360
HealthCheck360 was created with the employer's needs and the participant's experience in mind. We focus on reducing medical costs, while increasing employee engagement and productivity. This is accomplished by providing onsite biometric screenings, engaging participants through technology and programming, educating the participant with risk-specific targeted communications, and supporting positive behavior change through our Health Coaching and Condition Management programs.
Skills
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