Customer Care Advocate

Zenith American Solutions, Inc.; United States; On-site; USD 35,000 - 50,000; Full time

Job summary

Zenith American Solutions, Inc. is seeking a Customer Care Advocate to provide excellent customer service regarding eligibility, benefits, and claims status. Responsibilities include maintaining knowledge of assigned Plans, processing member information, and resolving complex inquiries.

The ideal candidate will have a high school diploma or GED and at least six months of experience in customer service. Proficiency in MS Office and strong communication skills are required. This role emphasizes integrity and commitment to customer satisfaction.

Qualifications

• Six months of experience in customer service, third-party administrator processing, or benefits administration.
• Strong work ethic and team player mentality.
• Ability to read, analyze, and interpret business materials.

Responsibilities

• Maintain knowledge of assigned Plan(s) and apply in job functions.
• Provide written and verbal customer service.
• Process enrollment and member information updates.

Skills

Customer service skills

Communication skills

Organizational skills

Detail-oriented

Education

High school diploma or GED

Tools

MS Office

Job description

Position Summary

The Customer Care Advocate provides customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. The role requires minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) as described in the job description/role.

Responsibilities

• Maintain current knowledge of assigned Plan(s) and effectively apply knowledge in all job functions.
• Provide written, verbal, or face‑to‑face customer service by responding to and documenting telephone and written inquiries in accordance with Plan(s) benefits.
• Update files, including documenting system notes of conversations or action taken.
• Perform tasks associated with the administration of retirement and health and welfare benefits such as processing and/or sending mailers or required forms requested by members and processing enrollment and member information updates in applicable systems.
• Distribute communications related to regulatory requirements.
• Initiate Action Requests to appropriate departments requesting adjustments to claims, retirement, and/or eligibility as necessary and follow up to ensure successful completion of Action Requests.
• Research and resolve complex and technical issues and irregularities.
• Perform 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.

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, the policy of Zenith American Solutions is 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].