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Job Overview
Location
Cali, Oregon, USA
Job Type
Full-time
Category
Data Science
Date Posted
December 4, 2025
Full Job Description
đź“‹ Description
- • Serve as the first point of contact for members who are confused, anxious, or overwhelmed by their health benefits. Every call you take is a chance to turn complexity into clarity and fear into confidence.
- • Provide expert, jargon-free explanations of medical, dental, vision, pharmacy, life, disability, FSA/HSA, and ancillary plans so members can make informed decisions about their coverage.
- • Guide employees and their families through open enrollment, new-hire onboarding, qualifying life events, and retirement transitions—translating dense plan documents into personalized recommendations.
- • Compare Marketplace exchange plans, COBRA, Medicare, and individual coverage options side-by-side, highlighting cost-sharing, provider networks, and prescription tiers so members choose the right plan the first time.
- • Investigate and resolve benefit discrepancies—deductible errors, denied claims, missing ID cards, or incorrect copays—by collaborating with carriers, HR teams, and internal departments until the issue is fully closed.
- • Document every interaction in our HIPAA-compliant CRM with meticulous accuracy, ensuring audit readiness and seamless continuity if a member calls back.
- • Maintain up-to-date knowledge of federal regulations (HIPAA, COBRA, ACA, ERISA, Medicare Part D) and state mandates so every answer you give is compliant and current.
- • Deliver an empathetic, objective, and sales-free experience that builds trust in the first 30 seconds of a call; your tone and patience often determine whether a member feels heard or hangs up frustrated.
- • Participate in ongoing calibration sessions, peer call reviews, and monthly knowledge-shares to keep your skills sharp and share best practices across the remote team.
- • Identify trends in member questions and escalate systemic issues to our product and compliance teams, directly influencing plan design improvements and knowledge-base updates.
- • Work a full-time, Monday-through-Friday schedule that flexes anywhere between 8:00 am and 10:00 pm EST, allowing you to balance personal obligations while still serving members coast-to-coast.
- • Operate from a distraction-free home office that we equip with a laptop, dual monitors, noise-canceling headset, and secure VPN so you can focus on delivering world-class service.
- • Contribute to team KPIs such as first-call resolution, average handle time, member satisfaction (CSAT), and quality assurance scores—metrics that reflect the real impact you have on people’s lives.
- • Mentor new hires once you complete our award-winning 6-week training program, accelerating their path to proficiency and reinforcing a culture of compassion and accuracy.
- • Celebrate wins—whether it’s a five-star member survey, a perfect QA score, or a heartfelt thank-you email—during our virtual huddles and quarterly recognition events.
🎯 Requirements
- • 1–2 years of customer service experience in a high-volume contact center or benefits administration environment
- • Demonstrated familiarity with U.S. health plans (medical, dental, vision), COBRA continuation, and tax-advantaged accounts such as FSA, HSA, or HRA (preferred)
- • Ability to explain complex benefits concepts in plain language to audiences with varying levels of health literacy
- • Proficiency in Microsoft Word, Excel, and web-based CRM or case-management systems
- • Quiet, secure home office with reliable high-speed internet and the ability to maintain HIPAA-compliant privacy standards
🏖️ Benefits
- • Fully remote role with company-provided laptop, dual monitors, headset, and secure VPN
- • Competitive base salary plus annual performance bonus eligibility
- • Comprehensive medical, dental, and vision insurance starting day one of employment
- • 401(k) with immediate company match and 100% vesting from day one
- • Tuition assistance up to $5,250 per year and paid certification programs (CEBS, CMS, HIPAA, etc.)
- • Generous PTO, paid volunteer days, and 11 observed holidays—including your birthday off
Skills & Technologies
Go
Remote
About Health Advocate
Health Advocate provides health advocacy and navigation, clinical care management, and mental health support to over 12,500 organizations and their members. The company utilizes personal support, data, and technology to improve health outcomes and lower medical costs for its clients' employees. They offer 24/7 support in over 250 languages, with services that are HIPAA-compliant and NCQA-certified & accredited. Health Advocate aims to provide a whole-person approach to support physical, emotional, relational, and financial well-being, leading to improved health outcomes and reduced absenteeism.
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