Claims Support Advocate

Job Title: Claims Support Advoctae

Start Date: March 17th, 2025

*6 month Contract with possible extension*

Pay Rate - $19.50-$21/hour

Schedule: Monday - Friday 8:00am to 5:00pm (In your time zone)

Training: 4 weeks Monday-Friday from 10:00 am to 7:00 pm Eastern Time / 7am to 4pm Pacific Time

Location: 100% Remote

Job Summary:

As a Claims Support Advoctae, you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality patient experience within our service level agreements. The Claims Support Coordinator role serves as a liaison between plan members, providers and health insurance companies to get claims issues resolved. The Claims Support handles all communication, paperwork, and negotiations with a health insurance carrier or provider on the behalf of the plan member.

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.

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)

About Medix?

Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.

Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for.

• Minimum Essential Coverage (MEC) plan
• Two different fixed indemnity plan add-ons
• Major Medical Plans, including 1 HSA Plan
• Dental
• Vision
• Short-term disability
• Life and AD&D

This year's recipient of the Business Ledger's "Entrepreneurial Excellence Growth Award"

Join our network of talented professionals!

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.