Job Summary
The Participant Advocate is responsible for delivering a consistently high level of service and support to program participants. This role serves as a primary point of contact and ensures each interaction is handled with professionalism, empathy, accuracy, and efficiency. Communication with participants, partners, vendors, and internal teams is conducted courteously and with attention to detail across phone, email, written correspondence, and in-person interactions.
Key Responsibilities
Maintain a strong working knowledge of benefit plan provisions, eligibility rules, and claims processes
Deliver a positive and professional participant experience at all times
Respond to phone calls, emails, walk-in inquiries, and written correspondence in a timely and accurate manner
Explain benefit information, claim payments, and reasons for claim denials in a clear and professional manner
Verify eligibility and benefits and research eligibility or claim-related issues as needed
Coordinate with external vendors and internal teams to resolve participant inquiries
Escalate complex or sensitive concerns to appropriate personnel for resolution
Accurately document all interactions and updates in the customer service system
Perform clerical and administrative tasks such as processing enrollment forms and maintaining records
Navigate and assist participants with the organization's website and online tools
Monitor call queues and manage messages through the call management system
Participate in special projects and support additional duties as assigned
Required and Preferred Qualifications
Minimum of 1 year of customer service experience
High school diploma or equivalent required
Ability to type at least 40 words per minute
Strong written and verbal communication skills
Proficiency in Microsoft Office (Word, Excel, Outlook)
Demonstrated initiative, reliability, and commitment to service excellence
Core Competencies
Dependable with consistent attendance and punctuality
Professional, calm, and empathetic demeanor when handling sensitive issues
Strong organizational and time-management skills
Ability to troubleshoot issues, gather relevant information, and collaborate with multiple stakeholders
Flexible and adaptable in a fast-paced, service-oriented environment
$58,000 - $62,000 a year
The Participant Advocate is responsible for delivering a consistently high level of service and support to program participants. This role serves as a primary point of contact and ensures each interaction is handled with professionalism, empathy, accuracy, and efficiency. Communication with participants, partners, vendors, and internal teams is conducted courteously and with attention to detail across phone, email, written correspondence, and in-person interactions.
Key Responsibilities
Maintain a strong working knowledge of benefit plan provisions, eligibility rules, and claims processes
Deliver a positive and professional participant experience at all times
Respond to phone calls, emails, walk-in inquiries, and written correspondence in a timely and accurate manner
Explain benefit information, claim payments, and reasons for claim denials in a clear and professional manner
Verify eligibility and benefits and research eligibility or claim-related issues as needed
Coordinate with external vendors and internal teams to resolve participant inquiries
Escalate complex or sensitive concerns to appropriate personnel for resolution
Accurately document all interactions and updates in the customer service system
Perform clerical and administrative tasks such as processing enrollment forms and maintaining records
Navigate and assist participants with the organization's website and online tools
Monitor call queues and manage messages through the call management system
Participate in special projects and support additional duties as assigned
Required and Preferred Qualifications
Minimum of 1 year of customer service experience
High school diploma or equivalent required
Ability to type at least 40 words per minute
Strong written and verbal communication skills
Proficiency in Microsoft Office (Word, Excel, Outlook)
Demonstrated initiative, reliability, and commitment to service excellence
Core Competencies
Dependable with consistent attendance and punctuality
Professional, calm, and empathetic demeanor when handling sensitive issues
Strong organizational and time-management skills
Ability to troubleshoot issues, gather relevant information, and collaborate with multiple stakeholders
Flexible and adaptable in a fast-paced, service-oriented environment
$58,000 - $62,000 a year