Claims Specialist

Job not on LinkedIn

🔥 52 minutes ago

🇺🇸 United States – Remote

💵 $19 - $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 and identify claims errors • Coordinate resolutions among members, carriers, and providers for timely claim processing • Manage cases involving Medicaid, Medicare, motor vehicle claims, and other benefit programs • Educate members about benefit plans and coverage details • Adhere to internal policies, procedures, and federal regulations • 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 • Advocate for members navigating healthcare claims and benefits

🎯 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 benefits 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 • Professional, distraction-free work environment during scheduled hours • Ability to perform prolonged sitting, computer use, frequent phone use, fingering, grasping, pulling hand-over-hand, and repetitive motions • Strong concentration, attention to detail, critical thinking, problem-solving, and verbal and written communication skills

🏖️ Benefits

• Training and comprehensive support • Opportunities for career growth and promotion from within • Medical, dental, and vision coverage • 401(k) with company match • PTO • Computer equipment, monitors, and other necessary technology provided • Advanced systems and comprehensive training • Collaborative team environment

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