Care Guide Advocate

Job Summary

Supporting both RN Care Coordinators and Utilization Management RNs, the full-time remote Care Guide Advocate will assist members and providers in navigating healthcare processes, ensuring a seamless experience through a blend of administrative, educational, and customer service functions.

Key responsibilities

• Provide exceptional customer service to patients and providers via phone and email, handling difficult situations with empathy
• Assist members with provider searches and navigation of digital programs, serving as a liaison for escalations and inquiries
• Contact provider offices for prior authorization needs and assist with claims adjustments while ensuring compliance with privacy regulations

Required qualifications

• High school diploma
• 2-3 years of experience in customer service
• Strong computer skills and experience with electronic medical records
• Intermediate knowledge of Microsoft Windows
• Ability to work effectively in a fast-paced environment with competing priorities