Claims Support Advocate (Temp)
Core
Liaison between plan members, providers, and health insurance companies to resolve member claim inquiries, handle communication and paperwork, and negotiate balances.
Role type
Claims Support Advocate (Customer Service)
Builds
Resolved claims and member account adjustments
Domain
Health Insurance / Claims Administration
Deliverable
client delivery
Required skills
Claims support experience, Health insurance knowledge, Customer service, Negotiation, Claim denial appeals, EOB interpretation, Medical record organization, Data analysis, Technical troubleshooting, Time management
Preferred skills
Medical billing/coding certification (CPC), College degree
Responsibilities
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; Communicate timely status updates to patients throughout the claims process; Negotiate with providers on plan member balances; Appeal claim denials from the insurance company; Contact providers and insurance companies to resolve claim concerns; Assist with understanding of explanation of benefits (EOBs); Assisting members with resolving claim errors or denials.
Seniority
Individual Contributor, 1-3 years experience
