Member Benefits Advocate - Fairos (On-Site if local to Amarillo) [Remote in Lubbock, Dallas, OKC, Tulsa, ABQ, Las Vegas]
Lubbock, TXAll locationsLubbock, TXAmarillo, TXDallas, TXOklahoma City, OKTulsa, OKAlbuquerque, NMDenver, COLas Vegas, NV On-site
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About the role
The OccuNet Company is an innovative company striving to reduce the cost of healthcare. We are a passionate group of people that care about affordable access to healthcare without sacrificing experience. We strive to make healthcare more intelligent, streamlined, and cost-effective. We offer industry-leading capabilities on negotiations-driven levers to contain rising healthcare costs while taking an experience-centric approach improving the health and well-being of those we serve. We pride ourselves on our tight knit culture based on the ‘outward mindset’ philosophy, emphasizing empathy, mutual respect, and seeing each other as “whole people.” We have an ambitious vision and are growing quickly. We are seeking team members who are excited about our growth, seeking to thrive in a fast-paced environment, and enthusiastic about developing their skills and career alongside us. : As a Member Benefits Advocate, you will serve at the forefront of The OccuNet Company’s experience-centric approach, improving the health and well-being of members. You will utilize your interpersonal abilities to provide members with exceptional support by delivering high-quality, professional, and efficient service across multiple channels. You will also liaise with members and providers to resolve inquiries to assist in the navigation of Reference-Based Pricing (RBP) health plans. : The Member Benefits Advocate is responsible for all inbound phone, chat, and email intake for the Fairos+ line of business. This communication comes from both health plan members and providers and can include, but is not limited to, quotation of benefits, eligibility inquiries, claim status, balance billing situations, member plan education, member physician or facility access issues, and other claim-related billing questions. Member Benefits Advocates are responsible for providing members and providers with requested information in a clear, timely, and professional manner. The team member is responsible for making outbound calls to providers, clients, and TPA partners to gather appropriate information or submit requests as needed to reach a timely resolution. The Member Benefits Advocate will also attend various meetings and training sessions to ensure they are fully capable and up to date on job roles and responsibilities.
What you'll bring
- High school diploma or equivalent required.
- 2+ years of customer service experience in member services, health care, or in a customer service or call center environment required.
- Strong understanding of benefit interpretation, including coverage and eligibility, member cost-share, plan limitations/exclusions, and prior authorization requirements.
- For remote candidates, ability to maintain a private, distraction-free workspace with a reliable high-speed internet connection suitable for handling confidential member information and phone-based work.
- Team-first mindset with a high level of motivation and drive.
- Naturally compassionate with an ability to navigate sensitive and challenging situations with care, patience, and professionalism.
- Passionate and proactive in contributing to organizational missions focused on improving member healthcare experiences.
- Persistent, detail oriented, and committed to seeing tasks through to completion with a high degree of accuracy.
- Bilingual verbal and written fluency in English and Spanish preferred.