Claims Specialist

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $18 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Health Advocate

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📣 Marketing

Healthcare • Consulting • Marketing

Health Advocate is a company dedicated to making healthcare easier for organizations and their members. Utilizing a combination of personal support, data, and technology, they offer a whole-person approach to improve health outcomes, reduce absenteeism and presenteeism, and lower costs. Their services include health advocacy and navigation, clinical care management, emotional health support, and personalized well-being programs. Health Advocate caters to over 12,500 organizations, offering 24/7 support in over 250 languages and ensuring HIPAA compliance and NCQA certification.

📋 Description

• Investigate billing discrepancies, identify errors, and coordinate resolutions among members, carriers, and providers • Manage cases involving Medicaid, Medicare, motor vehicle claims, and other benefit programs • Educate members on benefit plans and coverage details • Adhere to internal policies, procedures, and federal regulations when processing claims • Collaborate with team members and escalate unresolved issues to supervisors or carriers • Mentor new team members and share best practices • Contribute to continuous process improvements • Document and track cases using internal databases

🎯 Requirements

• At least 2 years of experience in healthcare, customer service, or claims • Experience analyzing claims, identifying root causes, and proposing practical solutions • Strong listening skills and ability to guide members with care and patience • Familiarity with plan documents, ACA guidelines, Medicare, COBRA, dental, vision, and behavioral health is a plus • Proficiency in MS Word and Excel • Comfortable using internal databases to document and track cases • Private, HIPAA-compliant workspace where confidential information cannot be viewed or overheard • Sufficient desk space for a dual-monitor workstation and related equipment • Reliable high-speed internet with minimum download speed of 200 Mbps • Ability to work in a professional, distraction-free environment during scheduled hours • Strong concentration and attention to detail • Critical thinking and problem-solving skills • Effective verbal and written communication skills

🏖️ Benefits

• Comprehensive medical, dental, and vision coverage • 401(k) with company match • PTO • Comprehensive training • Collaborative team support • Computer equipment, monitors, and other necessary technology provided • Competitive pay • Opportunities to mentor and contribute to continuous process improvements