Benefits & Eligibility Advocate | Customer Care

Zenith American Solutions, Inc.; Dallas (TX); On-site; USD 38,000 - 54,000; Full time

Job summary

Zenith American Solutions is seeking a Customer Care Advocate in Dallas to provide service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status.

The role requires navigating PHI/PII access per job duties, handling inquiries, and updating member information. It also involves processing enrollments, mailers, and regulatory communications while maintaining accuracy and confidentiality.

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.

Responsibilities

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

Skills

Communication

Team player

Integrity

Organizational skills

Attention to detail

Reading & interpreting policies

MS Office

Education

High school diploma or GED

Tools

MS Office

Job description

Zenith American Solutions is seeking a Customer Care Advocate in Dallas to provide service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status.

The role requires navigating PHI/PII access per job duties, handling inquiries, and updating member information. It also involves processing enrollments, mailers, and regulatory communications while maintaining accuracy and confidentiality.