Member Support Advocate | Employee Benefits

The Member Support Advocate serves as the primary day-to-day contact for assigned employer groups and their employees, delivering exceptional support related to benefits, claims, eligibility, and overall service for clients in the 50+ market segment. The Member Support Advocate manages an assigned book of business and serves as the direct point of contact for both HR contacts and employees.

As a member of the +One Employee Benefits Team, the Member Support Advocate partners with Account Managers, Client Success Managers, +One specialists, Producers, and carrier/vendor partners to deliver a responsive, high-quality client experience. Success in this role requires strong relationship-building skills, exceptional organization, the ability to prioritize competing demands, and a strong sense of urgency. This role builds on the foundation of the Employee Benefits Client Service Manager (CSM) role, with the added responsibility and autonomy of managing an assigned book of business.

Work Performed:

Member Support & Advocacy

• Act as the primary contact for employees and HR contacts, assisting with benefits-related questions and guiding them through enrollment, eligibility changes, and life event updates

• Support employees in navigating claims issues across medical, prescription, dental, vision, life, and ancillary benefits, escalating as needed

• Advocate on behalf of employees to carriers and vendors to resolve coverage, access, and claims concerns quickly and accurately

• Develop and maintain strong relationships with assigned HR contacts and employees, serving as a trusted resource for day-to-day benefits support and issue resolution

Eligibility & Administration

• Manage ongoing eligibility administration for assigned clients, including new hires, terminations, qualifying life events, demographic updates, dependent changes, and other employee status changes

• Coordinate eligibility changes with insurance carriers and benefit administration platforms to ensure timely and accurate processing

• Manage ID card requests

• Resolve eligibility and enrollment discrepancies by working collaboratively with clients, carriers, vendors, and internal teams

• Address access to care and other urgent service or administrative issues as needed

Communication & Education

• Provide clear explanations of plan benefits and coverage policies

• Assist employees in making benefits elections during initial or annual enrollment periods (in-bound phone calls and in-person as needed)

• Assist employees with provider searches and network access questions, and offer education on how to make the most of their benefits

• Support communication to employer groups on policy questions, collaborating with the account management team as needed

Systems & Documentation

• Accurately document all interactions and service workflows in the agency management system

• Coordinate with back-office support partners to ensure tasks are completed efficiently and on schedule

• Monitor and manage employee-facing tools and notifications, ensuring timely responses and updates

Team Collaboration

• Collaborate with Account Managers, Client Success Managers, consultants, and internal teams to meet client needs and deadlines

• Participate in internal meetings and client calls, contributing updates and documentation support

Additional Responsibilities

• Support service-related projects as assigned

• Identify trends in employee questions or issues and share feedback to improve processes and communication

• 1+ years of experience in employee benefits, brokerage, insurance carrier or HR/benefits administration

• Active Life & Health Insurance License, or the ability to become licensed within 60 days of employment

• Working knowledge of group benefit plans (medical, dental, vision, life, disability and voluntary benefits)

• Excellent communication and interpersonal skills (written and verbal) with a strong desire to help others

• Exceptional relationship-building and customer service skills

• Highly organized with strong attention to detail and follow-through; able to manage multiple tasks accurately

• Ability to manage multiple priorities and thrive in a deadline-driven, client-focused environment

• Demonstrated sense of urgency and commitment to responsive client service

• Ability to think critically, identify trends, determine root causes, and implement proactive solutions that prevent recurring issues

• Proficiency with Microsoft Office Suite (Word, Excel, Outlook and PowerPoint); comfort with technology and learning new systems

Preferred Education & Experience

• Bachelor’s degree in business, human resources, public health or a related field (or equivalent experience)

• Experience with Applied / Epic, CRM systems or benefits administration platforms

• Familiarity with ACA, ERISA, HIPAA, PCORI and RxDC reporting requirements

• Interest in or pursuit of industry certifications (CEBS, GBA, HIA)