Member Care Advocate II - Communities

Job Summary : Communities Member Care Advocates, who are our most visible representatives of our mission to raise the standard of healthcare for everyone, provide personalized service, by phone and chat. This role's primary focus will assist Included Health members, who are apart of the Black Community, by connect them with high quality, culturally affirming providers; answer their healthcare benefits questions; initiate healthcare services on their behalf; and assist them with navigating the complexities of the healthcare system. You will report to the Supervisor, Member Care Advocacy - Communities.

Responsibilities

• Provide administrative, financial, and clinical support with empathy and respect.
• Answer member calls; communicate with members by Phone and Chat; advocate with insurance companies and community healthcare providers to resolve medical billing problems; and research available benefits to identify the optimal resolution for the member.
• Collect, capture and document information gained in member interactions, including demographic and insurance information.
• Contribute to the provider directory by researching and contacting providers to ask a series of questions to collect comprehensive data about their practice and to evaluate if the provider is high-quality and provides culturally competent & affirming care.
• Follow set processes, procedures, and workflows in assisting members with :
• Advocate and navigate members, including finding new providers for members and assisting with locating resources and addressing Social Determinants of Health
• Educate members on their benefits coverage, including when to consider using their benefits, and how to use their benefits
• Triages / support claims and billing inquiries, prior authorizations, and other support questions.
• Connect members to IH clinical services, including virtual care services and second opinions.
• Uphold IH's mission of raising "The Standard of Healthcare for Everyone"
• Collaborate with other Member Care Advocates, Leadership, and other departments on specific member healthcare journeys.

Qualifications

Physical / Cognitive Requirements

Pay : The United States new hire base per hour target ranges for this full-time position are : Zone A : $ - $ equity benefits Zone B : $ / hour - $ / hour equity benefits Zone C : $ / hour - $ / hour equity benefits Zone D : $ - $ equity benefits This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.Starting base salary for you will depend on several job-related factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and great compensation package based on their roles and locations. Your Recruiter can share your geographic zone upon inquiry. Benefits & Perks : In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more : Remote-first culture401(k) savings plan through FidelityComprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)Paid Time Off ("PTO") and Discretionary Time Off ("DTO") 12 weeks of 100% Paid Parental leaveFamily Building & Compassionate Leave : Fertility coverage, $25,000 for surrogacy / adoption, and paid leave for failed treatments, adoption or pregnancies.Work-From-Home reimbursement to support team collaboration home office work Your recruiter will share more about the salary range and benefits package for your role during the hiring process.

Salary : $25,000