Member Services Advocate - Bilingual Spanish

Job Title: Member Services Advocate Department: Member Services

1. Job Summary:

The Member Services Advocate (MSA) provides specialized case management, advocacy and education to members while fulfilling the mission of Imagine360 Services, LLC. The Advocate guides and supports the member through the balance bill defense process while working closely with Client Services, our legal team and external stakeholders to facilitate timely issue resolution and ensure a positive member experience. As the member champion, MSAs provide best-in-class advocacy via comprehensive oversight, proactive outreach and white-glove service throughout the member journey.

2. Supervisory Responsibilities:

• None

3. Duties/Responsibilities:

• Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.
• Apply independent critical thinking and acumen to assist members with their balance bill issues and inquiries with a focus on influencing a positive member experience
• Handle and coordinate elevated internal and external member issue resolution with confidence and a sense of urgency. Act as point person for member inquiries, issues and concerns. Direct, quarterback and ensure timely issue resolution and remediation.
• Facilitate, influence and coordinate communication with members, clients, medical providers, in-house and external legal representation
• Establish and build a strong rapport with members and internal counterparts
• Track status and resolution of member inquiries and issues
• Maintain accurate and complete documentation and follow-up diaries during all stages of the process
• Collaborate with other internal stakeholders to address service issues and process/systemic enhancement opportunities
• Apply strong knowledge of HIPAA regulations
• Performs other duties as assigned by management

4. Education and Experience:

Required Education: College Degree or equivalent combination of college and work experience.

Preferred Education:

Required Experience: Delivering client-focused solutions based on customer needs experience.

Preferred Experience: Billing, insurance, healthcare, or legal environments experience.

Skills and Abilities:

• Proficiency in Microsoft Outlook, Microsoft Word, Excel, and internet navigation
• Ability to multi-task and thrive in a fast-paced entrepreneurial company
• Excellent written and verbal communication skills
• Advanced problem resolution skills
• Ability to make independent decisions and apply critical thinking based on practical knowledge and business acumen
• Excellent interpersonal skills and ability to maintain positive relationships
• Team player able to collaborate with other stakeholders
• Ability to stay focused and manage time appropriately
• Exude positivity with a desire and willingness to be a part of the Imagine360 Culture

Licenses or Certifications: None.

5. Physical Requirements:

• None