Health Benefits Advocate – Bilingual (EN/ES)

Building Service 32BJ Benefit Funds; New York (NY); On-site; USD 63,000 - 65,000; Full time

Job summary

Building Services 32BJ Benefit Funds is seeking a Health Services Patient Advocate in New York. You will maintain relationships with 5 Star Centers, support health fund programs, and assist members with choosing in-network providers.

The role requires strong organization, communication, and knowledge of healthcare terms. Bilingual English/Spanish is preferred. Working hours are 9:00 AM–5:00 PM, with a focus on member satisfaction and program enrollment.

Qualifications

• High School Diploma required.
• Associate degree or equivalent work experience in healthcare preferred.
• Microsoft Office (Word and Excel) proficiency required.
• Strong knowledge of healthcare industry and medical terminology.
• Insurance/managed care and claims processing background a plus.

Responsibilities

• Cultivate relationships with 5 Star Centers to address member issues from inquiry to resolution.
• Assist members with selecting providers and scheduling at 5 Star Centers.
• Review cases and communicate advantages of medical options; address limitations.
• Investigate member complaints and advocate when a complaint is filed against 5 Star providers.
• Identify patterns of Health Fund program issues and notify management.
• Address member concerns about Fund programs.
• Complete program enrollment processes for eligible members.
• Utilize Health Services Database to track interactions.
• Verify copays and research claims to identify billing errors.
• Assist with out-of-network and non-preferred providers and find in-network alternatives.
• Confirm provider network status by contacting offices.
• Conduct research on uncommon procedures for transition of care.
• Shadow new employees on workflows and case management.
• Participate in team meetings and special projects as requested.
• Reach out to members for upcoming fund initiatives.
• Reach out to unresponsive members to ensure process completion.
• Handle escalated outreach requests.
• Receive calls about Health Fund programs and billing issues.
• Escalate claims issues to management.

Skills

Organizational skills

Multitasking

Communication

Teamwork

Adaptability

Active listening

Medical collaboration

Creative thinking

Systems navigation

English proficiency

Education

High School Diploma

Associate degree

Microsoft Office (Word, Excel)

Healthcare knowledge

Insurance/Managed Care background

Tools

Microsoft Office

Job description

Building Services 32BJ Benefit Funds is seeking a Health Services Patient Advocate in New York. You will maintain relationships with 5 Star Centers, support health fund programs, and assist members with choosing in-network providers.

The role requires strong organization, communication, and knowledge of healthcare terms. Bilingual English/Spanish is preferred. Working hours are 9:00 AM–5:00 PM, with a focus on member satisfaction and program enrollment.