Billing Advocate Associate
Core
Investigate and resolve unpaid, underpaid, or denied medical claims through audits, appeals, and coordination of benefits to reduce member out-of-pocket costs.
Role type
Senior IC medical billing advocate
Builds
Insurance claims advocacy services for members, providers, and insurance carriers
Domain
Health insurance and medical billing
Required skills
Medical billing audits, claims appeals, coordination of benefits, medical coding familiarity (CPT/HCPCS/ICD), Salesforce, MS Office Suite, carrier portal navigation
Preferred skills
Salesforce expertise, data analysis for performance metrics, SOP development
Technologies
Salesforce, Microsoft Office Suite, Adobe, carrier portals
Responsibilities
Investigate and resolve denied or underpaid claims; track and submit out-of-network claims; identify coding errors or coverage mismatches; document claim activities in Salesforce; mentor new hires and lead onboarding; assist in drafting and refining Standard Operating Procedures (SOPs)
Seniority
Senior, hands-on IC with team leadership responsibilities