Claims Client Advocate – Employee Benefits

Sterling Seacrest Pritchard Inc; Atlanta (GA); Vor Ort; USD 42.000 - 56.000; Vollzeit

Zusammenfassung

Sterling Seacrest Pritchard Inc. in Atlanta, GA is seeking an Employee Benefits Claims Client Service Associate to advocate for client employees and HR on claims issues.

The role researches, escalates, and resolves problems with carriers across medical, dental, vision, life, disability, and voluntary plans, ensuring timely resolution and a strong client experience. The position emphasizes confidentiality of PHI, precise documentation, and collaboration with account teams to address denials,

Qualifikationen

• High attention to detail and accuracy in processing claims.

Aufgaben

• Serve as primary contact for client employees and HR on claims questions and denials.
• Open, track, and document claims inquiries with carriers until resolution.
• Research claim denials and explain coverage; assist with appeals.
• Coordinate with carrier reps, account managers, and clients to resolve issues.
• Assist with life, STD, LTD claims by helping employees complete forms and deadlines.
• Maintain a claims log and report trends, open issues, and turnaround times.
• Identify recurring issues and flag them to renewal and service teams.
• Maintain confidentiality of PHI per HIPAA and policy.

Kenntnisse

Attention to detail

Time management

Written and verbal communication

Proactive problem solving

Customer service

Jobbeschreibung

Sterling Seacrest Pritchard Inc. in Atlanta, GA is seeking an Employee Benefits Claims Client Service Associate to advocate for client employees and HR on claims issues.

The role researches, escalates, and resolves problems with carriers across medical, dental, vision, life, disability, and voluntary plans, ensuring timely resolution and a strong client experience. The position emphasizes confidentiality of PHI, precise documentation, and collaboration with account teams to address denials,