Member Services Advocate
Core
Deliver advanced advocacy services by guiding individuals through complex healthcare coverage scenarios, resolving escalated claims and billing issues, and partnering with providers and carriers to ensure accurate resolution.
Role type
Senior IC member services advocate (healthcare benefits)
Builds
Resolved claims and billing outcomes for members navigating complex health insurance and employer benefit situations
Domain
Health insurance, claims resolution, benefits administration
Deliverable
client delivery
Required skills
Independent assessment of complex issues, interpretation of plan details, claims resolution, provider/carrier coordination, stakeholder management, critical thinking, ownership of multi-layered issues
Preferred skills
Experience in health insurance, TPAs, provider offices, or benefits administration
Responsibilities
Guide individuals through complex coverage scenarios, resolve escalated claims and billing issues, partner directly with providers, carriers, and third-party administrators
Seniority
Senior, hands-on IC
