Membership Service Advocate – Customer Care

About the role

Helpware is looking for a Membership Service Advocate to join its customer‑care team. You will assist members with account updates, benefit education, and issue resolution, ensuring a seamless experience that reflects the company’s commitment to high‑quality support.

Key responsibilities

• Update member account details such as billing options, address, and phone numbers.
• Research and resolve premium billing discrepancies and prescription claim issues.
• Educate beneficiaries on plan benefits, cost‑sharing, coverage levels, and formulary details.
• Process mail requests for ID cards, formularies, and other member documents.
• Verify medication coverage, tier, and copay information; provide explanations for non‑covered drugs.
• Maintain accurate, concise member records and handle both inbound and outbound calls with high accuracy.
• Escalate complex member issues to management when needed.
• Achieve call‑quality targets, including a 95% quality score and answering 80‑85% of calls within 30 seconds.

Required profile

• Strong desire to help people and provide excellent customer care.
• High attention to detail and strong organizational skills.
• Positive demeanor, technical accuracy, and adherence to company policies.
• Understanding of CMS guidance and HIPAA regulations.
• Ability to communicate courteously with members, coworkers, and management.

Required skills

• Knowledge of CMS guidelines and HIPAA compliance.
• Experience with billing and prescription‑claims processes.

What we offer

• Full‑time position within a technology‑driven, global company.
• Opportunities for professional growth in a supportive team environment.