Service Advocate Iv Clinical Support -Remote

What is your impact?

The Service Advocate is focused on servicing current or potential customers, providers, agents, brokers, benefit administrators or consultants. The major accountability of this role is customer, provider, agent, broker, benefit administrator or consultant satisfaction.

What are your key responsibilities?

• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient certification and/or prior authorization requests.
• Verifies and obtains authorizations if needed. Enters referrals and documents communications, actions, and other data in departmental systems.
• Refers cases requiring clinical review to appropriate clinical professionals.
• Initiates and manages clinical referrals for members.
• Acts as a liaison between hospitals, physicians, health plans, vendors, patients, or referral sources.
• Provides customer service to plan members and/or providers by answering benefit questions, researching, and resolving issues and inquiries and ensuring members and providers understand the Company’s products and services.

What is required?

2+ years related work experience. Experience Details: Insurance Benefits, Authorizations, Customer service, Prior call center work

High school diploma or GED

What we offer:

As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

Medical, dental, vision, life and global travel health insurance.

Income protection benefits: life insurance, Short- and long-term disability programs.

Leave programs to support personal circumstances.

Retirement Savings Plan includes employer contribution and employer match.

Paid time off, volunteer time off, and 11 holidays

Additional voluntary benefits available; and

A comprehensive wellness program

Below is hard coded into JDX Template:

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Hourly: Salary Range: $17.98 - $28.46

Typical Hourly Hiring Range: $17.98 - $21.88

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

General Physical Demands

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive, and equitable culture for our employees and communities