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Member Care Advocate (MCA) - Bilingual

2 weeks, 6 days ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
HIPAA
Apply Now
Included Health

Included Health

Included Health is a healthcare company that provides cost-saving solutions for employers and health plans. They offer virtual care and navigation services, connecting millions with board-certified doctors and specialists for comprehensive and convenie...

Insurance
1K-5K
$106M raised
View All Jobs 22

Description

  • Answer inbound calls from English- and Spanish-speaking members with respectful, empathetic, plain-language support.
  • Explain benefits coverage, cost-sharing concepts, eligibility details, and next steps in the member’s preferred language.
  • Help members find and confirm in-network providers, update account information, and provide status updates on open requests.
  • Guide members through standard enrollment or scheduling steps for available programs such as virtual care.
  • Resolve clearly defined member questions end-to-end using established workflows and scripting.
  • Educate members to reduce confusion and minimize repeat contacts.
  • Use internal systems, knowledge bases, and carrier portals to research questions and determine the correct next step.
  • Document interactions and follow-up actions accurately and clearly to support continuity of care.
  • Meet or exceed quality audit and member satisfaction expectations.
  • Maintain a clear focus on Included Health’s mission while delivering consistent member support.

Requirements

  • Full fluency in both English and Spanish is required.
  • Bachelor’s degree plus at least 2 years of customer service or healthcare experience, or 5 years of relevant healthcare or benefits navigation experience.
  • Comfortable handling a high volume of inbound calls throughout the day using VoIP phone systems such as CXOne.
  • Strong familiarity with Google Workspace, Apple products, and CRM software, with the ability to learn proprietary tools quickly.
  • Exceptional customer service skills with the ability to de-escalate challenging situations and maintain a professional, friendly demeanor.
  • Strong verbal communication skills for explaining benefits, processes, and next steps clearly and confidently over the phone.
  • Strong written communication skills in English for accurate member documentation.
  • Ability to think critically within defined workflows, identify issues that do not look right, and use available resources to resolve well-scoped problems.
  • Ability to gather information, ask clarifying questions, and write concise summaries when follow-up by other teams is needed.
  • Understanding of HIPAA guidelines and commitment to maintaining member confidentiality.
  • Ability to work from a secure, distraction-free home office with reliable internet.
  • Availability to complete a 3-week paid training period with no planned time off; training schedule is 10 a.m. - 7 p.m. EST, Monday through Friday.

Benefits

  • Hourly rate of $22.00 for the U.S. new hire contract position.
  • Potential eligibility to transition to a permanent position after 5 months of contract work.
  • Medical, dental, and vision insurance, including extensive benefits through IH4IH from day one.
  • Free virtual primary care, urgent care, and behavioral health support from day one.
  • Employee Assistance Program and the Golden Ticket program for family and friends.
  • Work-from-home stipend to cover internet expenses.
  • 401(k) plan with a 50% company match on contributions up to 6%.
  • Paid time off, generous parental leave, company-wide holidays, and paid volunteer time.
  • Opportunities for career advancement and professional development.

Interested in this position?

Apply directly on the company website

Apply Now

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