Member Advocacy & Resolution Specialist

Wellmark, Inc.; Iowa (LA); On-site; USD 55,000 - 75,000; Full time

Job summary

Wellmark, Inc. is seeking a Customer Advocacy Specialist to be the trusted voice for members. You will coordinate, research and resolve complaints and live escalations while educating customers about products, benefits and tools.

The role emphasizes empathy, timely resolution, and data-informed improvements to the customer journey. You will partner across the organization to address concerns, deliver accurate solutions, and strengthen member relationships, influencing how Wellmark delivers

Qualifications

• High school diploma or GED required; associate degree preferred.
• 3+ years in health insurance operations or 4+ years handling customer complaints.
• Excellent verbal and written communication; strong relationship building.
• Strong de-escalation and empathy; maintains composure under pressure.
• Organized, detail-oriented with solid time management.
• Able to analyze data and present insights clearly.
• Familiar with electronic systems such as Microsoft applications and email.

Responsibilities

• Coordinate, research and resolve customer complaints, including live escalations.
• Advocate for customers and educate them on products, benefits and tools.
• Review customer feedback and identify opportunities for improvement.
• Ensure complaint resolution within required timeframes and communicate outcomes.
• Document complaint updates and route to appropriate teams for resolution.
• Develop and maintain relationships with internal stakeholders to resolve inquiries.
• Provide feedback to leadership on escalations and service experience improvements.
• Prepare complaint reports for trend analysis and share with relevant areas.
• Maintain knowledge of healthcare guidelines, policies and regulations.
• Perform outreach calls to members and providers about benefits and claims.
• Identify training opportunities for staff and suggest process improvements.
• Provide backup support to related case processing as needed.

Skills

Verbal communication

Written communication

De-escalation skills

Data analysis

Time management

Customer service

Ability to research

Relationship management

Education

High School Diploma or GED

Associate’s degree

Tools

Microsoft Office

Email tools

CRM / online tools

Job description

Wellmark, Inc. is seeking a Customer Advocacy Specialist to be the trusted voice for members. You will coordinate, research and resolve complaints and live escalations while educating customers about products, benefits and tools.

The role emphasizes empathy, timely resolution, and data-informed improvements to the customer journey. You will partner across the organization to address concerns, deliver accurate solutions, and strengthen member relationships, influencing how Wellmark delivers