Claims Support Advocate (REMOTE)

Job Details

Posting Date: 12-09-2024

Reference ID: 237359

Location: San Francisco, CA

Work Location: Remote

Discipline: Insurance

Job Type: 6-Month Contract with Possible Extension

Salary Expectations/ Pay Rate or Range: $19.50-$21.00/hr

Job Description

Responsibilities/ Job Duties: As a Claims Support Coordinator, 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.

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, 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.

Minimum Education and Experience Qualification Requirements:

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

Schedule/ Shift: M-F, 8:00am-5:00pm (in your time zone)

Benefits:

Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

Short Term Disability Insurance

Term Life Insurance Plan

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