Member Advocate
19 days ago
Dallas
Job Description About Us – Join a Team That’s Making a Real Impact in Healthcare At CareGuide, we are more than just a company—we are a team of problem-solvers and relationship-builders on a mission to make healthcare more affordable and accessible for millions. We take pride in fostering a supportive, collaborative environment where every team member is valued and has the opportunity to thrive both professionally and personally. We don’t just talk about our values, we live them. Our culture is rooted in transparency, teamwork, and a commitment to excellence. Whether it’s helping clients navigate complex healthcare costs or supporting each other in daily tasks, we believe strong relationships and well-structured processes lead to success. At CareGuide, we’re not just changing healthcare costs — we’re changing lives. Position Summary We are seeking a dependable and detail-oriented Member Advocate to provide thorough, accurate, and compassionate support to members navigating the complexities of the healthcare system. This role requires someone who is conscientious, steady under pressure, and committed to quality service while building trusted relationships with members. Member Advocates are the heart and voice of the organization, providing compassionate, strategic, and results-oriented support to members navigating complex healthcare systems. They serve as key liaisons between members, healthcare providers, internal teams, and external partners. From medical bill negotiation to facility coordination and case documentation, this role is integral to both member experience and organizational impact. Member Advocates ensure every member feels seen, heard, and supported while driving measurable savings and satisfaction outcomes. This role requires strong communication and organizational skills, the ability to handle sensitive medical information with discretion, and a commitment to maintaining compliance with HIPAA regulations. Candidates with experience as a Medical Secretary, Medical Administrative Assistant, Medical Records Specialist, Patient Service Representative, Medical Transcriptionist, or Medical Biller are strongly encouraged to apply. Bilingual candidates are highly desirable and will thrive in this diverse and dynamic environment. What YOU Will Do This posting provides a general overview of the role and does not include all daily responsibilities or essential job functions. • Serve as the member’s advocate by delivering professional, empathetic customer service and maintaining clear, reliable communication with members and healthcare providers., • Manage a caseload with accuracy and timeliness, coordinating appointments, provider research, financial assistance applications, and settlements., • Investigate and resolve medical billing concerns, negotiate cost reductions with providers, and identify prescription or financial aid programs to ease members’ financial burdens., • Draft and prepare settlement offers, appeal letters, and other documentation while ensuring compliance with HIPAA, legal requirements, and partner standards., • Enter and maintain accurate records in case management systems, track deadlines, monitor progress, and ensure cases are resolved effectively., • Address member complaints fairly, identify administrative or process gaps, and provide feedback to strengthen internal tools, workflows, and service delivery., • Collaborate with internal teams on case handling, structured reporting, and special projects to support organizational goals. Who YOU Are • High school diploma or equivalent required; Associate or Bachelor’s degree in a health-related, business, or social service field is a plus, • 2+ years of experience in healthcare navigation, billing, advocacy, case management, or a customer-facing role, • Experience working with vulnerable populations or navigating complex systems is strongly preferred, • Experience handling high-pressure situations with empathy, patience, and professionalism, • Prior experience in medical billing or insurance negotiations is a plus, • Bilingual abilities are a plus, • Experience in sensitive negotiations with healthcare providers and billing offices to achieve positive outcomes for members, • Experience in managing high caseloads and utilizing case management systems. Benefits Why CareGuide? • Make a Difference: Help businesses and employees lower healthcare costs while improving their access to care., • Structured & Supportive Environment: We provide clear processes, strong leadership, and a team-oriented culture where you can thrive., • Growth Potential: We invest in our people. This role has clear pathways for career advancement., • Work-Life Balance: Hybrid role (Dallas-based)., • The base salary range for this position is budgeted at $55,000-$60,000., • We also offer a competitive benefits package that includes medical, dental, and vision insurance, wellness resources, 401(k) matching, unlimited paid time off, and more.