Job description
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.
Location
Must be located within the Continental United States
Summary of Role
Our Claims Specialists play an important role in providing guidance, direction, and supporting our valued members to navigate the health care system.
They are responsible for handling assigned claims cases in a timely manner to identify opportunities to resolve the issue by working with plan documents, carriers, providers, and members; research billing issues to determine the possible cause of the error and assist with claims resubmission when needed to correct the issue; assist members with setting up payment arrangements which may include reaching out to healthcare providers to determine payment options and discussing options with supervisor; exercise exceptional customer service skills in an effort to optimize each contact with the member.
If you are someone who thrives in making a difference by helping others, have customer service experience, and are committed to making a contribution while growing your career in the benefits administration industry this is the job for you. We have training classes starting soon to help you build the successful career that you want - apply today!
Your Success
As a work from home associate, you’ll deliver a positive experience that solves members’ needs/challenges, while working to resolve issues.
Health Advocate offers all work equipment and a comprehensive new-employee training program to help you develop the knowledge and skills that will set you up for success in your role and in supporting our members.
Invested in you
At Health Advocate, you’ll have the ability to pursue your ambitions and grow your career. We’ve got you covered with a total rewards package that includes Robust Medical coverage, as well as Dental & Vision benefits, tuition assistance, 401(k) savings plan with company match, paid time off (PTO), paid holidays, Employee Assistance Programs and Wellness Programs.
Pay Rate
Hourly rate starts at $20.00 per hour.
Hours/Shift
This position is full-time (40 hours/week) Monday - Friday. Employees have flexibility to work any of our 8.5 hour shift schedules during our normal business hours of (8:00 am -10:00 pm EST). It may be necessary, given the business need, to work occasional overtime.
Job Summary
- Handle assigned cases in a timely manner to identify opportunities to resolve the issue by working with plan documents, carriers, providers, and members
- Research billing issues to determine the possible cause of the error and assist with claims resubmission when needed to correct the issue
- Assist members with setting up payment arrangements which may include reaching out to healthcare providers to determine payment options and discussing options with supervisor
- Understand Flexible Spending Accounts (FSA), Health Reimbursement Accounts (HRA), Health Spending Accounts (HSA), and benefits Summary Plan Descriptions (SPD) to resolve claims or billing issues
- Exercise exceptional customer service skills in an effort to optimize each contact with the member
Minimum Requirements
Education
- High School Degree or GED required
- Associate degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field is preferred.
Experience
- Minimum of one year customer service, healthcare, or claims processing experience required.
- Basic Knowledge of MS Word and Excel required
Knowledge of the following is preferred:
- Affordable Care Act (ACA) (Marketplace Navigation and Exchange plan review and comparison)
- Medicare (Part A, Part B, Part D, Advantage and MediGap Plans)
- Group Benefits (Fully Insured vs. Self-Insured)
- Medical Benefits (CDHP/HDHP, PPO, POS, and HMO Plans)
- Pharmacy Benefits
- Dental Benefits
- Vision Benefits
- Ability to interpret Explanation of Benefits (EOBs).
- Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees.
Company Overview
Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 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.
Learn more
Health Advocate
https://www.healthadvocate.com/site/
Awards
2022:
- Best in Biz Award: Most Customer-Friendly Company of the Year
- Great Place to Work
2021:
- Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Silver Winner
- Stevie® Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19), Bronze Winner
- Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)
2020:
- National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up
- Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver)
Health Advocate is an Equal Opportunity Employer that does not discriminate on the basis of race, color, sex, age, religion, national origin, citizenship status, military service and veteran status, physical or mental disability, or any other factor not related to job requirements. We respect and value diversity, and are committed to the principles of Equal Employment Opportunity.
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)
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