IFP Customer Service Advocate - National Remote
About the position
Responsibilities
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs))
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
Requirements
• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 2+ years of customer service experience
• Ability to work full-time, Monday - Friday between 7:00am - 6:00pm CST including the flexibility to work occasional overtime given the business need
Nice-to-haves
• Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
• Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
• Sales or account management experience
• Bilingual fluency in English and Spanish
Benefits
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
Apply Now
Apply Now
Responsibilities
• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs))
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
Requirements
• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 2+ years of customer service experience
• Ability to work full-time, Monday - Friday between 7:00am - 6:00pm CST including the flexibility to work occasional overtime given the business need
Nice-to-haves
• Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
• Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
• Sales or account management experience
• Bilingual fluency in English and Spanish
Benefits
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
Apply Now
Apply Now