Patient Advocate Representative

Role Overview

As a Patient Advocate Representative, you will be responsible for handling member, client, and provider inquiries related to balance billing situations, educating the process and negotiations for closing out the balance bills. This role works independently under minimal supervision to complete the assigned job responsibilities.

What You Will Do

Manages facility, provider, and member inquiries, appeals and balance billing, including correspondence. Reviews and resolves balance bills and appeals with providers, through negotiations.

Why It Might Be a Fit

This role requires a proactive, self-starter with an elevated level of professionalism, organization, and flexibility. The ideal candidate will have strong organizational skills, demonstrating strong attention to detail, and effective communication skills, both oral and written.

Requirements

• Minimum high school diploma. Baccalaureate degree (BA/BS) from an accredited college or university preferred.
• Two (2) plus years’ experience in a medical healthcare claims role dealing with facilities, providers and members is required.
• Background in healthcare claims management environment including provider hospital billing, claims adjudication and administration or the ability to interpret benefit plans/Explanation of Benefits
• Negotiation experience a plus
• A proactive, self-starter
• An elevated level of professionalism, organization, and flexibility
• Strong organizational skills, demonstrating strong attention to detail.
• Effective communication skills, both oral and written
• Ability to manage high call volume.
• Ability to multi-task effectively
• 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.
• Solid problem solving skills with the ability to determine and take the appropriate course of action for resolution.
• Should possess a moderate to elevated level of claim editing, coding, RVU and CMS-based pricing knowledge with an emphasis in researching solutions for the above items as needed.
• Bilingual preferred
• PC literate, including Microsoft Office products and web-based applications.
• Regular, timely attendance

Benefits

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• Paid Parental Leave
• 401(k) + match
• Employee Stock Purchase Plan
• Generous Paid Time Off – accrued based on years of service
• 10 paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

Originally posted on Himalayas