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
Associate medical billing advocate (claims resolution)
Builds
Insurance claims advocacy products 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), carrier portal navigation, Salesforce documentation
Preferred skills
Salesforce experience, MS Office proficiency, document management tools
Responsibilities
Investigate and resolve denied claims via follow-up and escalation; Track and submit out-of-network claims; Identify coding errors or coverage mismatches; Document claim activities in Salesforce; Mentor new hires and conduct case reviews; Assist in drafting and refining Standard Operating Procedures (SOPs)
Seniority
Associate, individual contributor