Senior Center - Member Advocate 171-1001 at CommunityCare

Tulsa, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

27 Dec, 25

Salary

0.0

Posted On

28 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Phone Etiquette, Verbal Interactions, Written Communication, Customer Service Orientation, Active Listening, Confidential Information Handling, Health Insurance Knowledge, Microsoft Office Proficiency

Industry

Insurance

Description

JOB SUMMARY: The Member Advocate I serves as a liaison between members and CommunityCare, ensuring a high-quality member experience through personalized support and problem resolution. The Member Advocate I helps members navigate the healthcare system, understand their benefits, and resolve any issues or barriers to care. This role is essential in promoting member satisfaction, retention, and trust. KEY RESPONSIBILITIES: Serve as the primary point of contact for members who need support with navigating their CommunityCare health plan. Assist members in understanding their benefits, claims, provider options, prior authorizations, and other services. Identify and resolve member issues, including escalated complaints and barriers to care. Coordinate with internal departments such as Utilization Management, Claims, Provider Services, and Enrollment Services to resolve concerns. Educate members on wellness programs, preventive services, and available resources. Track and document member interactions in accordance with regulatory and CommunityCare. Ensure compliance with CMS, state, and other regulatory requirements in all member communications. Assist members with scheduling appointments at many of the events we host. Assist with inbound and outbound calls as needed to support the initiatives of the Senior Center. Performs other duties as required or assigned. QUALIFICATIONS: Excellent phone etiquette, face-to-face verbal interactions, and written communication skills. Strong customer service orientation and active listening skills. Ability to handle sensitive and confidential information with professionalism. Knowledge of health insurance terminology, benefits, and regulatory guidelines. Proficiency in Microsoft Office EDUCATION/EXPERIENCE: High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred. 2+ years of experience in healthcare and/or customer service. Experience with health insurance plans strongly preferred. CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

Responsibilities

The Member Advocate I serves as a liaison between members and CommunityCare, ensuring a high-quality member experience through personalized support and problem resolution. This role involves assisting members in navigating the healthcare system and resolving issues related to their health plan.