Member Care Advocate (MCA)

Member Care Advocates (MCAs) provide member-centered support in a high-volume environment, answering inbound calls and resolving core member issues. They must have strong critical thinking and ownership to navigate member needs effectively.

Requirements

• Bachelor’s degree with a minimum of 2 years of customer service or healthcare experience, OR 5 years of relevant experience in healthcare or benefits navigation
• Comfortable handling a high volume of inbound calls throughout the day using VoIP phone systems (e.g., CXOne)
• Strong familiarity with Google Workspace, Apple products, and customer relationship management (CRM) software, with the ability to learn proprietary tools quickly
• Exceptional customer service skills, with the ability to act as a member advocate, de-escalate challenging situations, and maintain a professional, friendly demeanor
• Strong verbal communication skills for phone interactions, including the ability to explain benefits, processes, and next steps clearly and confidently
• Strong written communication skills in English for accurate, clear documentation of member interactions
• Demonstrated ability to think critically within defined workflows, identify when something doesn’t look right, and use available resources to resolve well-scoped issues
• Comfortable gathering information, asking clarifying questions, and structuring a clear summary when additional follow-up by other teams is needed
• Understands and follows HIPAA guidelines and maintains member confidentiality at all times
• Ability to work from a secure, distraction-free home office with reliable internet, and the discipline to succeed in a remote environment

Benefits

• Medical and Dental insurance
• Vision insurance
• Employee Assistance Program
• Golden Ticket program
• 401(k) plan with a 50% match on contributions, up to 6%
• Paid time off
• Generous parental leave
• Company-wide holidays
• Paid volunteer time

Originally posted on Himalayas