Customer Care Advocate

American Benefit Plan Administrators, Inc.; Las Vegas, Northern (NV, KY); Hybrid; USD 40,000 - 52,000; Full time

Job summary

Zenith American Solutions is seeking a Customer Care Advocate to provide customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. The role handles PHI/PII access per job description and ensures accurate documentation and communications.

The position requires a high school diploma or GED and at least six months in customer service or benefits administration, with strong integrity and writing skills.

Qualifications

• High school diploma or GED required.
• Six months of experience working 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 actions taken.
• Processes and/or sends mailers or required forms as requested by members.
• Processes and/or sends correspondence related to member or claims status.
• Processes enrollments and updates member information in applicable systems.

Skills

Customer service

Team player

Communication

Detail orientation

Reading & interpretation

MS Office

Education

High school diploma or GED

Tools

MS Office

Job description

Title: Customer Care Advocate Department: Customer Care Union: Teamsters 986 Grade: 20 FLSA: Non-exempt Hours per week: 40

Position Summary

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties and 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 telephone and written inquiries in accordance with various Plan(s) benefits. Updates files, including documenting system notes of conversations or action taken. Performs tasks associated with the administration of retirement and health and welfare benefits such as; Processing and/or sending mailers or required forms as requested by members. Processing and/or sending correspondence related to member or claims status. Processing enrollments and updating member information in applicable system(s). Distributing communications related to regulatory requirements. Initiates Action Requests to appropriate departments requesting adjustments to claims, retirement, and/or eligibility as necessary. Follows up to ensure successful completion of Action Request. Researches and resolves complex and technical issues and irregularities. Performs other duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Six months of experience working 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.

Preferred Qualifications

• Call center experience in benefits claims, billing, or eligibility.

Other Disclaimers

*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at [e-mail], and we would be happy to assist you.

About Zenith American Solutions

Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day. Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We’re always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more! At Zenith American Solutions, we take immense pride in fostering a positive, respectful, and supportive work environment that provides challenging opportunities while supporting a healthy work/ life balance. Our organizational culture is founded on principles of integrity, honesty and respect for all stakeholders, including our employees, clients, and business partners. With a low employee turnover rate and a high rate of internal promotions and transfers, the Zenith team is proud to be a part of an 80-year legacy of excellence. Our employees embody a spirit of integrity, take immense pride in their work, and are enthusiastic about referring others to join our team.