The role:

The Advocacy Specialist supports the Board’s mission by faithfully administering and delivering superior service to members and employers. This individual acts on behalf of plan members, mid-councils, congregations, and employers by interpreting and promoting the value of the Benefits Plan and Assistance Program. This individual is responsible for the prompt review and resolution of all escalations related to medical plan benefits as well as non-medical plan issues that are beyond the scope of Plan Operations Tier 1 Service Specialists and our Care Navigation partner.

What you will do:

• Provide support to all members experiencing unique or complex healthcare needs.
• Review and resolve all escalated service inquiries requiring immediate attention promptly.
• Collaborate with business partners and internal teams to resolve escalated service inquiries.
• Partner with care navigation provider to deliver superior support of member healthcare needs.
• Resolve emergency enrollment and eligibility inquiries.
• Ensure accurate claims processing by managing the Medicare Small Employer Exception (SEE) process.
• Oversee the bi-annual Age 65 Mailing Project to advising members of their Medicare options and confirming employer (PINs) size to determine primacy between Medicare and the active medical plan.
• Ensure members in receiving correct claim adjudication by coordinating with our medical plan vendor weekly and monthly coordination of benefit reporting.
• Remain informed about key plan benefits, including benefit changes, and communicate important developments to members and employers, as needed.
• Monitor emerging trends and reports important developments and key issues to the Plan Ops reporting and analytics.

What you need to succeed in the role:

• Strong customer service orientation with the drive to deliver an exceptional customer experience with a concentration in health and wellbeing benefits.
• Experience working with customer relationship management systems.
• The ability to interpret and explain Benefits Plan and Administrative Rules.
• The ability to multi-task and produce accurate work timely and offer excellent service to members while functioning in a high production-oriented environment.
• The ability to work as an effective team member.
• Excellent verbal, written and interpersonal communication skills.
• The ability to understand the special needs of Benefits Plan members and relate effectively over the telephone in a caring manner.
• A strong desire to listen, identify issues, formulate alternatives, and make appropriate decisions
• An ability, interest and desire to stay current via seminars, industry literature, and formal training and development.

Our recruiting process is simple.

If you’re interested in a role at the Board of Pensions, apply online at pensions.org. If your skills match an open position, one of our recruiters will set up a phone or Microsoft Teams interview to discuss your interests, background, and skills. They’ll also answer any questions you might have. If you are selected to continue with the recruitment process, you will meet the hiring manager and other relevant team members.

To protect the health of our staff, we encourage everyone to receive FDA-approved vaccinations that may reduce the spread of certain infectious diseases, such as the flu and COVID-19.

We are an Equal Opportunity Employer.

The Board of Pensions of the Presbyterian Church (U.S.A.) is proud to be an Equal Opportunity Employer. We value diversity, equity, and inclusion and do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, veteran status, disability status, or any other applicable characteristics protected by law.