Customer Care Advocate 1

Zenith American Solutions, Inc.; Dallas (TX); On-site; USD 37,000 - 48,000; Full time

Benefits offered by this job

Health, vision, and dental coverage

401(k) with company match

Paid time off (PTO)

Growth opportunities

Job summary

Zenith American Solutions is seeking a Customer Care Advocate to support participants, beneficiaries, unions, and providers. You will handle eligibility, benefits, and claims inquiries with accuracy and care while maintaining up-to-date records.

The role emphasizes strong communication, teamwork, and attention to detail. Prolonged desk work is expected, with a 40-hour work week and non-exempt status under the FLSA.

Qualifications

• Minimum: High school diploma or GED.
• Six months of customer service, benefits processing, or related experience.
• Strong work ethic and team-oriented mindset.
• Ability to communicate clearly, both orally and in writing.
• Excellent organizational skills and attention to detail.
• Ability to read and interpret benefit plans and regulations.

Responsibilities

• Provide customer service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status.
• Respond to inquiries in written, verbal, or face-to-face formats and document interactions accordingly.
• Update files with system notes and maintain accurate records.
• Process enrollments and update member information in the system.
• Distribute communications related to regulatory requirements and process related mailers.

Skills

Customer service

Clear communication

Team player

Detail oriented

Reading benefits documents

Education

High school diploma or GED

Tools

MS Office

Job description

Title: Customer Care Advocate

Department: Customer Care

Union: Local 154

Grade: 2

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.
• Bilingual.
• 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.

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!