Claims Support Advocate (Temp) - Included Health
View Company Profile- Job Title
- Claims Support Advocate (Temp)
- Job Location
- Remote
- Job Description
- Responsibilities:As a Claims Support Advocate (CSA), you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality member experience within our service level agreements. The CSA serves as a liaison between plan members, providers and health insurance companies to resolve member claim inquiries. The CSA handles all communication, paperwork, and negotiations with a health insurance carrier or provider on the behalf of the plan member.Required Qualifications:
- Your primary objective is to provide effective and timely customer service for members, providers, insurers and clients regarding health care claims
- Ensure timely follow-up on requests for accounts to be reviewed
- Organize health insurance paperwork and medical record documentation
- Demonstrate knowledge of proprietary software and other required technology (Google apps, Slack, etc)
- Communicate timely status updates to patients throughout the claims process
- Negotiate with providers on plan member balances
- Appeal claim denials from the insurance company
- Contact providers and insurance companies to resolve claim concerns
- Assist with understanding of explanation of benefits (EOBs)
- Assisting members with resolving claim errors or denials. Ideally to recoup or lower their medical expenses
- Collaborate with peers and management across functions
- Understand the evolving business requirements and adapt the operational processes to meet those requirements
- Speak clearly, confidently and maintain professionalism as well as friendly member interactions while demonstrating persuasion in overcoming objections
- Ability to handle a fast-paced, dynamic environment with competing priorities
- Model a culture reflective of our core company values
- Gain and retain a thorough understanding of the team and company policies, processes, software, etc
- Including other duties and responsibilities as assigned by leadership
- 3+ years of direct claims experience in a health plan, carrier, provider, or advocacy environment, with responsibility for reviewing, processing, denying, appealing, and resolving medical claims
- 1 year experience in customer service roles
- Passion for providing support
- Prior work experience in a claims support and health insurance role
- Ability to take meticulous notes and document actions taken
- Highly effective communication, problem resolution and organizational skills
- Demonstrated ability to meet goals in a rapidly changing environment
- Excellent data and overall analytical skills
- Excellent written and verbal communication skills
- Proven record of excellent time management and prioritization skills
- Ability to troubleshoot basic technical issues
- Proven track record of driving measurable efficiency results.
Preferred Qualifications:- College degree preferred (additional experience in lieu of college degree will be considered)
- Medical billing/coding certification (CPC) is beneficial, but not required
Physical/Cognitive Requirements:- Prompt and regular attendance at assigned work location.
- Ability to remain seated in a stationary position for prolonged periods.
- Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, computer and other office-related equipment.
- No heavy lifting is expected, though occasional exertion of about 20 lbs. of force (e.g., lifting a computer / laptop) may be required.
- Ability to interact with leadership, employees, and members in an appropriate manner.
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Included Health Company Size
Between 1,000 - 5,000 employees
Included Health Founded Year
2020
Included Health Total Amount Raised
$2,280,003