Provider Relations & Claims Advocate - Remote

Overview

The Claims & PR Advocate will handle inbound claim calls from members and providers, resolving inquiries related to claim status and provider contracts.

In Short

• Service inbound claim calls from members and providers.
• Occasional outbound calls for claim issue resolution.
• Assist with understanding claim processing.
• Verify claim status and educate on billing protocols.
• Handle authorizations to ensure proper claim payments.
• Provide follow-up on issues via outbound calls.
• Assist with contract-related inquiries and updates.
• Utilize multiple applications to service inquiries.
• Maintain professionalism in all communications.
• Work in a structured environment focusing on call handling.

Requirements

• Customer Service experience required.
• Experience in behavioral health claims preferred.
• Ability to work in a virtual team environment.
• Strong interpersonal and communication skills.
• Effective listening and organizational skills.
• Technical capabilities for various claim systems.
• Strong time management skills.
• Effective typing and PC skills.
• Bachelor's degree required.
• Internet connection must meet specified requirements.

Benefits

• Comprehensive health-related benefits starting day one.
• 401(k) with company match.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays.
• Annual bonus plan eligibility.
• Support for whole health and well-being programs.