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 ProvidersTracks 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.
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
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Job ID: 126339
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