Member Advocate - Customer Service

Job Title: Memebr Advocate - Hive Advocate

Status: Non-Exempt

Why this role is important: Navigating the healthcare system can be very confusing. Where should you go? How much will you have to pay? Will the service be covered? Is this doctor good? These are just a few questions members often have when seeking care. Aither's Member Advocates are there to provide answers to these questions and to help guide individuals.

What you’ll do:

• Listen. Actively listen. Listen with perceptive, compassionate and considerate ears like its your Grandma on the other end of that line.

• Help. Help our members with whatever they need - even when they do not know what that is. It might be explaining benefits, scheduling an appointment, helping them find a high quality physician or helping them understand what it will cost.

• Proactively support members by reviewing current healthcare usage, followed by outreach to members to provide recommendations and education on opportunities that will help them save on healthcare expenses.

• Utilize internal information and tools available to provide accurate information to members and problem solve a member's concern.

• Be well versed in point of care solutions to support the steerage to our partners in care

• Identify HighPriority needs that require immediate action.

• Take support to the next level by negotiating Single Case Agreements, Direct Contracts and identifying alternative medication sourcing as required.

• Document all actions taken to support members.

• Manage Balance Bill Process for Hive clients.

• Engage. Engage your teammates when needed to resolve the members questions completely while you are on the call.

• Learn. Learn how to battle healthcare costs. We will teach you.

• Save. Leverage what you learn to help our members receive high quality care at a reasonable cost.

• Invent. Help us invent new ways to battle health care costs.

What you’ll bring:

• High school diploma or GED required

• Associates Degree preferred

• Knowledge of CPT codes, ICD-10 codes and Medical Terminology a plus

• Experience with lots and lots of phone calls, coming in and going out

• Ability to remain patient, level-headed and cool under pressure

• Talent to communicate clearly - when you explain it, people get it

• PC and Windows experience

• Desire to help people and get them to those ah! moments

• A love for taking on difficult situations and finding creative solutions

• Natural talent for digging until you find a solution

• The attitude that anything worth doing is worth doing right - every single time

• Talent for ensuring nothing falls through the cracks on your watch

• Strong self management and time management skills

• Ability to maintain confidentiality

• The motivation to learn and constantly improve processes

• Mindset of a team-player - you'll be ready to jump in and help on any Aither task

Compensation Range: $21-$28

This position is hybrid after training is completed

Physical Requirements:

Prolonged period sitting at a desk and working on a computer and the ability to lift 15 pounds

Job Type: Full-time

Pay: $20.00 - $28.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Experience level:

• 2 years

Shift:

• 8 hour shift

Weekly day range:

• Monday to Friday

Work setting:

• Call center
• Office

Work Location: In person