Customer Advocate II
Core
Provide assistance to healthcare providers and Indian Health Services (IHS) by researching, analyzing, and responding to inquiries regarding claims, pricing, and coordination of benefits.
Role type
Customer Advocate II (Claims & Benefits Specialist)
Builds
Resolution of claims and pricing inquiries, process improvement recommendations
Domain
Health Insurance / Claims Administration
Deliverable
client delivery
Required skills
Claims analysis, pricing issue resolution, coordination of benefits, data entry, medical terminology knowledge, independent decision making
Preferred skills
Disease management experience, anatomy knowledge, testing criteria proficiency
Responsibilities
Respond to telephone and written inquiries, resolve claims and pricing issues, act as liaison between providers and IHS, make process improvement recommendations
Seniority
Entry-level to Mid-level, hands-on IC
