Customer Care Advocate

American Benefit Plan Administrators, Inc.; San Francisco, Northern (CA, KY); Hybrid; USD 30,000 - 41,000; Full time

Benefits offered by this job

Health coverage

Vision coverage

Dental coverage

Retirement savings 401(k) plan with会社マ

Job summary

Zenith American Solutions is hiring a Customer Care Advocate to provide service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. The role requires handling PHI/PII access per job description and maintaining knowledge of multiple plans.

Responsibilities include documenting inquiries, processing enrollments, and communicating regulatory updates. Strong communication, detail orientation, and MS Office proficiency are essential;

Qualifications

• High school diploma or GED.
• Six months of customer service or benefits processing experience.
• Strong work ethic and team player mentality.
• Integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Strong organizational skills with attention to detail.
• Ability to read, analyze, and interpret business materials and benefit plans.
• Proficient with MS Office tools.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and applies it in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to inquiries and documenting them per plan benefits.
• Updates files, including system notes of conversations or actions taken.
• Processes and/or sends mailers or required forms to members.
• Processes and/or sends correspondence related to member or claims status.
• Processes enrollments and updates member information in applicable systems.
• Distributes communications related to regulatory requirements.
• Initiates Action Requests to departments for adjustments to claims, retirement, and eligibility as needed.
• Follows up to ensure completion of Action Requests.
• Researches and resolves complex issues and irregularities.

Skills

Customer service mindset

Team player

Communication skills

Organization

Reading & interpretation of documents

MS Office proficiency

Education

High school diploma or GED

Tools

MS Office

Job description

Title

Customer Care Advocate

Department

Customer Service

Union

OPEIU

Grade

16

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.
• Bilingual.

Important Notice

*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.

Working Conditions / Physical Effort

Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.

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.

Compensation

We are displaying salary. This rate is intended for hires into this location. $25.75/hr

About the Company

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. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families. Real People. Real Solutions. National Reach. Local Expertise.

Benefits

• Health coverage
• Vision coverage
• Dental coverage
• 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.