Company: Universal Health Services, Inc.
Posted on: March 8, 2023
Job Summary: The Care Advocate is a dedicated health care
professional who compassionately and quickly advocates for our
member's care through educating members and providers of the
benefit plans, scheduling member appointments, navigating bills,
and arranging transportation for Medicare lines of business.
- Accountable for gaining and keeping up-to-date with the
detailed knowledge of member health plans and effectively
communicating benefits, plan coverage and procedures to members,
- Receives inbound calls from members, providers or any
internal/external source as needed to resolve an issue
- Make outbound calls to respond to customer inquiries
(telephonically or email), providing information about member plans
and services, and resolving customer issues
- Guides members with their healthcare needs byexplaining
benefits, solving claim concerns, helpingfind a doctor, setting
medical appointments, coordinating Medicare member transportation
to provider officesthrough telephone, online chats or e-mails.
- Responsible for developing and maintaining a strong rapport
with members and providers through active listening, empathy and
compassion when resolving questions, problems or complaints.
- Meets call tracking production standards to assure a timely
response and single contact resolution where possible.
- Documents all inquiries (100%) and complaints (100%) in
Customer Tracking Software to assure timely response and closure;
identify trends in specific areas for improvement and opportunities
for communication and education to the Manager of Member Service
- Research provider bills looking for member liability and
discrepancies pertaining to wrongful charges.
- Responsible for sending member notifications communicating
primary care provider terminations in a timely manner.
- Works with the Manager of Member Service to modify, develop and
update existing procedures and/or methods within the department to
- Works closely and effectively with other areas to the Health
Plans Division to resolve specific member problems or
- Partners with internal departments to create a seamless
experience for members and providers to resolve potential
- Promotes good public relations for Health Plans Division and
maintains member and/or employee confidentiality and
professionalism at all times.
- Maintains all Compliance and HIPAA regulations at all times
- Minimum High school Diploma, AA degree preferred
- Basic understanding of medical and health care terms and
- Strong communication skills both written and verbal.
- Positive customer service skills including active listening,
empathy and compassion when resolving member and provider
questions, problems or complaints
- Resourceful, good problem solving abilities, attention to
detail, and teamwork orientation.
- Technical proficiency as it relates to software navigation,
web-based program organization, and a clear understanding of office
- Flexibility to meet the changing demands of the business.
- Ability to be present, complete any task assigned, consistently
do the right thing, work together toward the business goals
- Appetite for growth, learning and working in a fast-paced,
- Ability to learn new lines of business, software, platforms and
methods for processing member and provider service requests.
Keywords: Universal Health Services, Inc., McAllen , CARE ADVOCATE, Other , Mcallen, Texas
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