Member Benefits Advocate - Fairos (On-Site if local to Amarillo) [Remote in Lubbock, Dallas, OKC, Tulsa, ABQ, Las Vegas]

Role overview This position supports members of employer-sponsored healthcare plans built around Reference-Based Pricing (RBP). The Advocate serves as the primary point of contact, guiding members and providers through benefits, claims, and care-navigation questions while delivering an empathy-driven, experience-first service experience.

Responsibilities - Handle inbound phone, chat, and email inquiries from plan members and providers, covering benefit quotes, eligibility, claim status, balance billing, plan education, and provider-access issues. - Place outbound calls to providers, clients, and third-party administrator partners to gather information or escalate requests needed for resolution. - Interpret plan documents, Explanation of Benefit (EOB) statements, and cost-share details to explain coverage clearly to non-technical audiences. - Collaborate with internal Account Management and Contracting teams to address recurring member challenges and improve processes. - Maintain HIPAA and Department of Labor compliance standards, including accurate documentation of every interaction. - Anticipate member needs and proactively offer solutions that improve the overall care journey.

Requirements - High school diploma or equivalent. - 2+ years of customer service experience in member services, healthcare, or a call-center environment. - 1+ years directly interpreting and explaining medical, dental, or vision plan benefits to members and providers. - Working knowledge of coverage and eligibility rules, member cost-share, plan limitations, exclusions, and prior-authorization requirements. - Compassionate, patient communication style suited to sensitive and high-stress situations. - For remote candidates, a private, distraction-free workspace with reliable high-speed internet suitable for handling confidential information.

Nice to have - Bilingual verbal and written fluency in English and Spanish.

Benefits and work setup - 401(k) with employer matching. - Medical, dental, and vision insurance. - Health savings account. - Paid time off. - On-site option for candidates local to one location; remote option available for candidates in several other specified metropolitan areas.