Research Analyst- Family Health Advocate- Remote

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Job Summary:

The role of the Family Health Advocate-Research Analyst is an exciting and integral role in providing meaningful advocacy support to members and their families through personalized resource and referral facilitation, issue resolution and healthcare navigation. In this role you will provide research to support and resolve cases originating from our Family Health Advocates that require additional follow up. Case follow-ups include but are not limited to the coordination of benefits, health claim appeals, re-submissions and/or re-coding, EOB reviews and researching provider availability and scheduling appointments.

Essential Job Functions:

• Appointment availability
• Aid with ordering durable medical equipment (DME)
• Coordinate issue resolution with providers, payers or 3rd parties for:
• Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision plans
• Support for spending accounts, pharmacy, and disability.
• Research and documentation of issue resolutions.
• Complex pharmacy inquiries
• Work closely with assigned Family Health Advocates to ensure timely resolution and follow up of tasks
• Research and resolution to eligibility, claims issues, ID card issues, grievances/appeals, utilization management (UM) status including but not limited to medical, dental, and vision plans
• Primary duties include but are not limited to:
• Complex spending account inquiries
• Support follow up needs from Family Health Advocate calls for the following:
• Claims adjustments
• Grievances and appeals submissions
• Community resource search
• Timely management of assigned queue tasks requiring research and resolution
• Utilization management intake or status

Specific Skills/ Attributes:

• Ability to communicate effectively in both voice and chat channels, including critical thinking skills, effective typing, grammar, and spelling skills.
• Excellent multi-channel communication and problem-solving skills
• Proficient in general office tool use and navigation (i.e., Microsoft)

Qualifications:

• Health Guide/Advocate/Navigator
• Medical Assistant
• Medical Secretary/Clinic Manager
• Customer service experience within a healthcare contact center, provider office, or healthcare institution
• Experience in successful resolution of high level/sensitive customer service issues.
• High school / GED diploma
• 2-yr associates degree in healthcare/health sciences OR equivalent experience in healthcare, preferably with research and resolving benefits and claims, OR held one or more of the following positions:
• Claims Specialist/Processor
• Medical Coder

Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.