Health Advocate Hiring for Claims Specialist at Remote Full Time

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate’s supervisors are promoted from within the company. Plus, consider these perks: Benefits for full- and part-time employees, generous paid time off, and fun employee events, like holiday luncheons and dress down days!

Position Overview

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to: work with medical providers to negotiate balances outstanding on members claims.

The appropriate candidate would be responsible for managing multiple claims cases, interfacing with internal staff and external providers to understand and negotiate claims balances. The appropriate candidate will follow up to ensure all aspects of the negotiation are documented and processed for member satisfaction.

Essential Job Functions

• Handles Member calls & cases for claims fee negotiation
• Negotiates Consumer/Member Medical Claims with Healthcare Providers
• Send and Acknowledge receipt of Contracts from Consumers/Members and Providers
• Tracks all Settlements
• Reports Settlement results within the system and Statistics to Management
• Works with other Health Advocate units, including training when requested
• Works with product development VP to refine process and improve the Consumer/Member Settlement product
• Supports Sales & Marketing as SME, including participation in meetings with Current and Prospective Customers
• Provide benefit and claims consultation and support when appropriate to all internal departments.

Requirements

• Claims or Call center experience preferred
• Bachelor’s Degree or applicable work experience.
• Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing.
• Assertive, self-confident, and resilient.
• Basic computer skills.
• Ability to search and identify resources through the internet.
• Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals.
• Ability to interpret Explanation of Benefits (EOBs).
• Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race. color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, pregnancy, genetic information or any other consideration prohibited by law or contract.

Job Type: Full-time

About US:
Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For nearly 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.

Silver winner – Best in Biz Award 2020

Most Customer-Friendly Company of the Year

Silver winner – Stevie® Award 2020

Healthcare Customer Service Department of the Year

Bronze winner – Stevie® Award 2020

Most Valuable Response by a Customer Service Team

Equal Opportunity Employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race. color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, pregnancy, genetic information or any other consideration prohibited by law or contract.

VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans.

PAY TRANSPARENCY NONDISCRIMINATION PROVISION

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)