Claims Support Advocate (Temp)

Job Summary:
 
As a Claims Support Advocate (CSA), you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality member experience within our service level agreements. The CSA serves as a liaison between plan members, providers and health insurance companies to resolve member claim inquiries. The CSA handles all communication, paperwork, and negotiations with a health insurance carrier or provider on the behalf of the plan member.
 
 
 
Responsibilities:
Your primary objective is to 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
Demonstrate knowledge of proprietary software and other required technology (Google apps, Slack, etc)
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. Ideally to recoup or lower their medical expenses
Collaborate with peers and management across functions
Understand the evolving business requirements and adapt the operational processes to meet those requirements
Speak clearly, confidently and maintain professionalism as well as friendly member interactions while demonstrating persuasion in overcoming objections
Ability to handle a fast-paced, dynamic environment with competing priorities
Model a culture reflective of our core company values 
Gain and retain a thorough understanding of the team and company policies, processes, software, etc
Including other duties and responsibilities as assigned by leadership
 
Qualifications:
 
1 year experience in customer service roles
3 years...