MEMBER EXPERIENCE ADVOCATE

PERMA FAIR; Georgia; On-site; USD 50,000 - 65,000; Full time

Job summary

PERMA FAIR is seeking a Member Experience Advocate in the United States to deliver exceptional service to members, resolving inquiries, and fostering loyalty. You will collaborate with physicians and facilities to ensure a white glove member experience, emphasizing communication and problem-solving.

The ideal candidate has 2+ years in healthcare customer service, experience with TPA and RBP, and strong Microsoft 365 and CRM proficiency. This role requires full-time work in the U.S.

Qualifications

• High school diploma or equivalent required; associate’s degree preferred.
• 2+ years in customer service, member advocacy, or related field.
• Minimum 2 years healthcare experience.
• Experience with third party administrator (TPA).
• Experience with Reference Based Pricing (RBP) methodology.
• Triage and prioritization of requests based on business and medical factors.
• Knowledge of medical benefit plans and confidentiality requirements.

Responsibilities

• Serve as the primary contact for members via phone, email, chat, or other channels.
• Provide accurate information on products, services, policies, and procedures.
• Resolve member concerns promptly; escalate when needed.
• Build and maintain positive member relationships with personalized solutions.
• Investigate and resolve complaints, collaborating with internal teams as needed.
• Identify trends and suggest process improvements to enhance efficiency.
• Maintain accurate records of interactions and resolutions in company systems.
• Ensure all communications comply with policies, procedures, and regulations.

Skills

Communication

Interpersonal

Problem-solving

Microsoft 365

CRM systems

Multitasking

Confidentiality

Education

High school diploma

Associate’s degree

Tools

Outlook

Teams

Excel

Job description

Position Summary

The Member Experience Advocate is responsible for delivering exceptional service and support to members, ensuring their needs are met efficiently and effectively. This role focuses on enhancing member satisfaction, resolving inquiries, and fostering positive relationships to promote loyalty and trust. You will also work closely with physicians and facilities to facilitate care focused consistently on delivering a white glove member experience. The ideal candidate will possess strong communication skills, problem-solving abilities, and a commitment to providing outstanding customer experience.

Key Responsibilities

Member Support:

• Serve as the primary point of contact for members, addressing inquiries via phone, email, chat, or other communication channels.
• Provide accurate information regarding products, services, policies, and procedures.
• Resolve member concerns promptly and professionally, escalating issues when necessary.

Relationship Building:

• Build and maintain positive relationships with members by understanding their needs and delivering personalized solutions.
• Actively listen to member feedback and identify opportunities to improve their experience.

Problem Resolution:

• Investigate and resolve member complaints or issues, ensuring timely and satisfactory outcomes.
• Collaborate with internal teams to address complex problems and implement solutions.

Process Improvement:

• Identify trends in member inquiries and recommend process improvements to enhance efficiency and satisfaction.
• Contribute to the development of best practices and training materials for member support.

Documentation and Reporting:

• Maintain accurate records of member interactions, inquiries, and resolutions using company systems.

Compliance and Standards:

• Adhere to company policies, procedures, and regulatory requirements.
• Ensure all communications align with organizational values and standards of professionalism.

Qualifications

Education and Experience:

• High school diploma or equivalent required; associate’s degree preferred.
• 2+ years of experience in customer service, member advocacy, or a related field.
• Minimum 2 years of healthcare experience.
• Minimum 2 years of experience working with third party administrator (TPA).
• Minimum 2 years of experience working with Reference Based Pricing (RBP) methodology.
• Experience with triage- appropriate prioritization of requests based on both business and medical considerations.
• Ability to identify opportunities to streamline workflows and enhance the member experience.
• Knowledge of medical benefit plans.
• Ability to maintain a high level of integrity and confidentiality of medical information.
• Strong organizational skills.
• Strong time management skills.
• Authorized to work in the United States on a full-time basis without Company sponsorship.

Skills and Competencies:

• Exceptional verbal and written communication skills.
• Strong interpersonal skills with the ability to empathize and connect with members.
• Problem-solving and critical-thinking abilities.
• Proficiency in Microsoft 365 tools (e.g., Outlook, Teams, Excel) and CRM systems.
• Ability to multitask and prioritize in a fast-paced environment.
• Ability to maintain a high level of integrity and confidentiality of medical information.

Personal Attributes:

• Detail-oriented and organized.
• Positive attitude and a commitment to delivering excellent service.
• Strong time management skills.
• Strong organizational skills.
• Adaptable and open to feedback for continuous improvement.

Salary for this position ranges from $50,000.00-$65,000.00. The base pay offered will be determined on factors such as experience, skills, training, location, certifications, and education. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.

Qualifying positions will also be eligible for comprehensive benefits, such as participation in family medical and dental insurance programs, 401K plan, and PTO.

Must be authorized to work in the United States on a full-time basis without Company sponsorship.

PERMA FAIR is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, gender, affectional or sexual orientation, gender identity or expression, national origin, ancestry, nationality, age, disability (physical or mental), marital or domestic partnership or Civil Union status, pregnancy, family medical history or genetic information, atypical cellular or blood trait, military service or any other status protected by law.