Member Services Patient Advocate

Member Services Patient Advocate

JOB SUMMARY: As a Member Services Patient Advocate, you will be responsible for addressing all member communications related to balance billing situations, educating the process, and updating on the negotiations for closing out the balance bills.

This position may be located anywhere in the Eastern, Central, Mountain or Pacific time zones. Work schedule based on business needs between the hours as follows:

• 5:30 am to 5:00 pm PT
• 6:30 am to 6:00 pm MT
• 7:30 am to 7:00 pm CT
• 8:30 am to 8:00 pm ET

JOB ROLES AND RESPONSIBILITIES:

1. Manages member phone line and answers all inquiries.

2. Ensure member inquiries are addressed timely; including education.
3. Ensures clear documentation of events associated with a medical claim.
4. Manages a daily running inventory of claims, prioritizing one's work schedule accordingly.
5. Addresses all member emails, incoming calls, texts and inquiries.
6. Maintains daily tasks of sending letters to members and recording contact information.
7. Keeps the Lead Patient Advocate direct report informed of critical matters.
8. Collaborates, coordinates, and communicates across disciplines and departments.
9. Assists in maintaining a clean, safe and unobstructed workplace environment.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate commitment to the Company's core values.
12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High-Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:

This position works under direct supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through training and experience to complete the job responsibilities as assigned. Work may often be varied and complex in nature. The incumbent may have regular contact amongst all levels of internal and external sources to complete objects, keeping the needs of external and internal customers in mind when making decisions and taking action.

JOB REQUIREMENTS (Education, Experience, and Training):

• Minimum High School Diploma
• Experience in a medical healthcare claims role dealing with facilities, providers and members
• Background in healthcare claims management and the ability to interpret benefit plans/Explanation of Benefits
• Proactive, self-starter
• Ability to manage high call volume
• Experienced and highly skilled in working with phone inquiries.
• Possesses exceptional multi-tasking and strong communication skills, both oral and written.
• A high level of professionalism, organization and flexibility.
• Detail focused
• Self-Motivating personality and a professional demeanor that promotes a team environment.
• Manages self and time so as to meet provided timeframes and deadlines, becoming flexible when necessary
• Able to work comfortably in a fast-paced environment
• Bilingual preferred
• Excellent organizational skills demonstrating strong attention to detail.
• PC literate, including Microsoft Office products and web-based applications
• Required licensures, professional certifications, and/or Board certifications as applicable
• Individuals in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
• Regular, timely attendance

COMPENSATION
The salary for this position is $21 per hour. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.

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