Claims Resolution Specialist

Included Health; United States; On-site; USD 26,174 - 35,817; Full time

Job summary

Included Health is seeking a Claims Support Advocate to join our team in the United States. The role focuses on delivering high-quality member experiences by handling claim inquiries, coordinating with providers and insurers, and resolving claim issues within service level agreements.

Candidates should have 1 year of customer service experience and 3 years in revenue cycle or carrier roles, with strong communication and organizational skills. Medical billing/coding certification is a plus.

Qualifications

• 1 year experience in customer service
• 3 years revenue cycle or carrier experience
• Medical billing/coding certification is beneficial but not required
• College degree preferred or equivalent work experience

Responsibilities

• Provide effective and timely customer service for members, providers, insurers and clients regarding health care claims
• Organize health insurance paperwork and medical record documentation
• Negotiate with providers on plan member balances
• Appeal claim denials from the insurance company
• Explain benefits (EOBs) to members
• Assist with resolving claim errors or denials
• Collaborate with peers and management across functions
• Maintain professionalism and clear communication in a fast-paced environment

Skills

Customer service

Communication

Problem resolution

Time management

Note taking

Education

College degree preferred

CPC certification beneficial

Tools

Google apps

Slack

Job description

Included Health is seeking a Claims Support Advocate to join our team in the United States. The role focuses on delivering high-quality member experiences by handling claim inquiries, coordinating with providers and insurers, and resolving claim issues within service level agreements.

Candidates should have 1 year of customer service experience and 3 years in revenue cycle or carrier roles, with strong communication and organizational skills. Medical billing/coding certification is a plus.