Claims Support Advocate

Medix Healthcare:

Overview:

Claims Support Advocate

Schedule:

Training (4 Weeks) M-F 7AM-4PM PST

Post Training Schedule: M-F 8AM-5PM (In Your Time Zone)

Pay: $19.50-21/HR (Depending On Experience/Location)

Location: Fully Remote! Equipment Provided

HIRING ASAP

MUST HAVE QUALIFICATIONS:

• 1+ years claims experience required within hospital or large provider groups (10+ providers)
• 2+ years of Healthcare Collections and A/R
• Passion for providing support
• Highly effective communication, problem resolution and organizational skills
• Demonstrated ability to meet goals in a rapidly changing environment
• Excellent data and overall analytical skills
• Proven track record of driving measurable efficiency results
• Medical billing/coding certification (CPC) beneficial, but not required
• College degree preferred (additional experience in lieu of college degree will be considered)

Responsibilities:

• Your primary objective is to provide effective and timely customer service for members, providers, insurer 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, etc)
• Negotiate with providers on plan member balances
• Challenge denials of claims by the insurance company
• Communicate with medical offices, hospitals, laboratories, etc... in an effort to obtain relevant records for the patient's case
• Contact providers and insurance companies to resolve claim concerns
• Assist with understanding of explanation of benefits (EOBs)
• Enabling members to get the errors fixed and recoup or lower their expenses by resolving their: medical bills, denied medical claims, medical letters of appeal
• Analyze and identify trends and patterns related to member billing complaints
• 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 have a friendly phone demeanor while demonstrating persuasion in overcoming objections
• Be able to handle a fast-paced dynamic environment with competing priorities
• Model a culture reflective of our Core Company Values; gain and maintain a thorough understanding of the Patient Care Team policies, processes, software, etc.

Selling Points

• Opportunity To Work For A Large Health Plan

• Remote!

3-5 Must Have Skills/Qualifications

• 1+ years claims experience required within hospital or large provider groups (10+ providers)
• 2+ years of Healthcare Collections and A/R
• Passion for providing support
• Highly effective communication, problem resolution and organizational skills
• Demonstrated ability to meet goals in a rapidly changing environment
• Excellent data and overall analytical skills
• Proven track record of driving measurable efficiency results
• Medical billing/coding certification (CPC) beneficial, but not required
• College degree preferred (additional experience in lieu of college degree will be considered)

Nice to Have Skills

• Bilingual In Spanish

• Quick Learner

• Computer Savvy

Schedule:

Training (4 Weeks) M-F 7AM-4PM PST

Post Training Schedule: M-F 8AM-5PM (In Your Time Zone)

Pay:

$19.50/HR-$21/HR (Depending On Experience/Location)

#MedixWest

Medix is acting as an Employment Business in relation to this vacancy.