Member Advocate

Professional Benefit Administrators leads with one guiding principle, provide exceptional benefit

administration for self-funded health plans. Brokers who choose to partner with PBA will benefit from

an ally who values cost containment, flexibility, responsiveness, member advocacy, transparency, and

results. PBA collectively aligns through the organization’s core values of:

• Work together and respect each other,

• Be dedicated to the customer,

• Be accountable and do what you say,

• Take initiative and be willing to learn and

• Generate positive energy.

The Member Advocate is responsible for providing excellent customer service to our members and

providers. This position requires strong communication skills, problem solving, and overall client

satisfaction. This individual reports to the Member Advocacy Manager. Please see below for a more

in-depth overview of daily responsibilities and skills required for this position.

Responsible for:

• 50 incoming calls per day to provide quality customer service to callers.

• Developing and maintaining problem solving skills and troubleshooting abilities for the

purpose of assisting callers and going the “extra mile” when necessary.

• Accurately identifying callers needs, conducting research and assisting with issue resolution

• Provide clear communication with focus on empathy and professionalism.

• Referring to any claims or issues that require adjustments, processing, repricing, or other

intervention according to guidelines.

• Ask appropriate questions and listen actively to identify specific questions or issues while

documenting required information in computer systems.

• Own issues through to resolution on behalf of the member in real time or through

comprehensive and timely follow-up with the member.

• Responding to portals and all e-mails timely.

• Placing follow-up calls to members and providers, timely.

• Maintaining a working knowledge of plan benefits.

• Suggesting process improvement ideas.

• Presenting problems/trends to Management.

• Performing other duties as assigned to support PBA’s Mission, Vision and Core Values.

Skills required for this position:

• 2 years in a customer service-oriented role which required communicating over the phone.

• Maintain a positive work atmosphere by behaving and communicating in a manner so that you

get along with customers, clients, co-workers, and management.

• TPA/Insurance Company environment or medical billing office experience preferred.

• Multitask with numerous customer service computer screens.

• Excellent typing skills, clearly documenting call notes

• Active listener and provide empathy and understanding to callers.

• Strong verbal communication and interpersonal skills.

• Ability to quickly learn and adapt to new concepts/systems.

• Professional and responsible work ethic.

• Ability to interface with various levels of the organization.

• Proficient in Microsoft Office Suite products.

Benefits and Compensation:

• PBA offers a wide range of benefits including medical, dental, vision, life insurance, AD&D,

critical illness, accidental illness, FSA, disability and 401k.

• The range for this role is $21-$24 per hour

Essential Functions Statement

• This role is a remote role requiring the individual to have a private, dedicated space free from

distractions.

• In this position you must be able to exchange accurate information/communication with co-

workers, customers and vendors.

Physical Demands

• This is largely a sedentary role which requires the ability to sit for long periods of time.

• The person in this position constantly operates a computer and other office machinery, such

as a calculator, copy machine, and computer printer.

• To perform the physical requirements of the position, the employee must be able to have

manual dexterity in his or her hands in order to keyboard; see; hear, talk, walk; sit; stand;

report to work and stay at work for regularly scheduled work shifts and occasional overtime;

communicate clearly, cooperatively, and professionally.

Professional Benefit Administrators is an equal opportunity employer. In accordance with anti-

discrimination law, it is the purpose of this policy to effectuate these principles and mandates.

Professional Benefit Administrators affords equal employment opportunities to all employees and

applicants and specifically prohibits any and all discrimination and harassment based on race,

race-related traits, color, religion, national origin, ethnicity, ancestry, military status, sex,

pregnancy, sexual orientation, gender identity, disability (mental or physical), age, marital status,

citizenship status, unfavorable military discharge, genetic information, order of protection status,

and any other protected status under federal, state, and local law. Professional Benefit

Administrators conform to the spirit as well as to the letter of all applicable laws and regulations.