Medical Cost Negotiator & Claims Specialist

***MUST BE LOCATED WITHIN THE CONTINENTAL US***

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company.

Position Overview:

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to: work with medical providers to negotiate balances outstanding on members claims. The appropriate candidate would be responsible for managing multiple claims cases, interfacing with internal staff and external providers to understand and negotiate claims balances. The appropriate candidate will follow up to ensure all aspects of the negotiation are documented and processed for member satisfaction.

Essential Job Functions

• Handles Member calls & cases for claims fee negotiation

• Negotiates Consumer/Member Medical Claims with Healthcare Providers

• Send and Acknowledge receipt of Contracts from Consumers/Members and Providers

• Tracks all Settlements

• Reports Settlement results within the system and Statistics to Management

• Works with other Health Advocate units, including training when requested

• Works with product development VP to refine process and improve the Consumer/Member Settlement product

• Supports Sales & Marketing as SME, including participation in meetings with Current and Prospective Customers

• Provide benefit and claims consultation and support when appropriate to all internal departments.

Requirements

• Claims or Call center experience preferred

• Bachelor's Degree or applicable work experience

• Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing.

• Assertive, self-confident, and resilient.

• Basic computer skills.

• Ability to search and identify resources through the internet.

• Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals.

• Ability to interpret Explanation of Benefits (EOBs).

• Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees.

Health Advocate is an Equal Opportunity Employer that does not discriminate on the basis of race, color, sex, age, religion, national origin, citizenship status, military service and veteran status, physical or mental disability, or any other factor not related to job requirements. We respect and value diversity, and are committed to the principles of Equal Employment Opportunity.

Job Type: Full-time

Pay: $20.00 - $24.00 per hour

Benefits:

• Tuition reimbursement
• Paid time off
• Referral program
• Employee assistance program
• Health insurance
• Life insurance
• Dental insurance
• Health savings account
• Employee discount
• Flexible spending account
• 401(k) matching
• Vision insurance
• 401(k)

Physical setting:

• Call center

Schedule:

• Monday to Friday
• 8 hour shift

Work Location: Remote