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Customer Care Advocate (Customer Care Representative)

May 14, 2026

Job Description: Summary:The Customer Care Advocate (CCA) resolves customer inquiries via telephone, walk in, mail, fax, web chat, off-phone work, and email concerning, but not limited to, contract benefits, claim payments, and enrollment in accordance with LOS, Corporate Service strategy, NCQA, and legislative requirements. The Customer Care Advocate provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance member & provider satisfaction/retention. The B version of this role requires the individual to speak Spanish fluently.Essential Responsibilities/Accountabilities:All Levels<ul><li>Provides service among the customers and business partners while responding in a professional, efficient, and timely manner to enhance member and provider satisfaction and retention. Must exercise tact, patience, and professionalism at all times in responding to internal/external customers.</li><li>Documents, researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with LOS, NCQA, HIPAA, NYSDOH, CMS and other legislative requirements.</li><li>Utilizes appropriate resources, resolves customer inquiries accurately & efficiently resulting in acceptable quality, first contact resolution/provider satisfaction, and performance.</li><li>Provides outreach related to claims, onboarding, effectuation, retention, provider inquiries, and any other complex inquiry.</li><li>Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution.</li><li>Participates in meetings, training, and skill development to support career path and individual development plans.</li><li>Is knowledgeable and enthusiastic about the company and our products and/or services.</li><li>Identifies and follows through on issues impacting the Health Plan and customer experience.</li><li>Develops effective internal working relationships for improved communication and collaboration.</li><li>Shares ideas and solutions to improve processes, procedures, and systems.</li><li>Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.</li><li>Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.</li><li>Regular reliable attendance is expected and required.</li><li>Performs other functions as assigned by management.</li></ul>Minimum Qualifications:NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.Level I:<ul><li>High School diploma or equivalent, customer service experience preferred.</li><li>Entry level position. Duties performed under close supervision.</li><li>B Version: Bi-lingual English/Spanish required (must have ability to speak Spanish fluently).</li><li>Ability to multi-task to efficiently resolve customer concerns, by actively listening to the customer, navigating screens on the computer, typing call documentation, and speaking to the customer simultaneously.</li><li>Computer skills required, including the ability to navigate in a Windows environment. Skillful at working between multiple programs and applications at the same time.</li><li>Organizational skills, reasoning, problem solving skills, effective and diplomatic communication, ability to prioritize, multitask, and work in fast paced environment and remain professional and focused under multiple pressures and demands.</li><li>Successfully attends and completes all training as defined by the business unit.</li></ul>Level Il - in addition to Level I requirements:<ul><li>Rating of “Performing” or above on the Agent Dashboard and Competencies for a minimum of 9 out of 12 months.</li><li>Successfully complete training as required by the business unit.</li><li>Ability to efficiently resolve complex & escalated issues with minimal direction.</li><li>Advanced system and navigational skills.</li><li>Expanded communication skills across multiple channels including, but not limited to, voicemail, email, web chat, outbound calls, membership growth, retention, etc.</li><li>Takes accountability and ownership of issues and resolution with minimal supervision.</li></ul>Level III - in addition to Level II requirements:<ul><li>Rating of “Performing” or above on the Agent Dashboard and Competencies for a minimum 10 out of 12 additional months.</li><li>Successfully complete training as required by the business unit.</li><li>Self-sufficient in resolving complex & escalated issues.</li><li>Provide mentoring and support to new hires and peer group.</li><li>Assist with tasks assigned by management that require advanced problem-solving skills.</li><li>Demonstrates functional global thinking and takes initiative to recognize opportunities within the team.</li></ul>Physical Requirements<ul><li>Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.</li><li>The ability to hear, understand, and speak clearly while using a phone, with or without a headset.</li><li>Ability to travel across the Health Plan service region for meetings and/or trainings as needed.</li></ul>************In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.Equal Opportunity EmployerPlease note: There may be opportunity for remote work within all jobs posted by the Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Compensation Range(s):Grade N2: Minimum $20.00 Maximum $20.00 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...