Claims Support Advocate

Included Health; United States; Remote; USD 42,000 - 66,000; Full time

Job summary

Included Health, Inc. is seeking a customer-focused claims support professional to help members, providers, insurers, and clients navigate health care claims efficiently.

You will organize paperwork, explain benefits, and communicate updates throughout the claims process while working with providers and insurers to resolve denials in a fast-paced, collaborative environment.

Qualifications

• 1 year of experience in customer service roles.
• 3 years of revenue cycle or carrier experience.
• Prior work experience in a claims support and health insurance role.
• Excellent written and verbal communication skills.
• Strong analytical, organizational, and problem-resolution skills.
• Ability to handle a fast-paced, dynamic environment with competing priorities.
• Proficiency with Google apps, Slack, and other required technology.

Responsibilities

• Provide effective and timely customer service for members, providers, insurers, and clients regarding health care claims.
• Negotiate with providers on plan member balances and appeal claim denials from insurance companies.
• Organize health insurance paperwork and medical record documentation.
• Communicate timely status updates to patients throughout the claims process.
• Assist members with understanding explanation of benefits (EOBs) and resolving claim errors or denials.
• Contact providers and insurance companies to resolve claim concerns.
• Collaborate with peers and management across functions to meet evolving business requirements.

Skills

Customer service

Revenue cycle experience

Claims support

Communication skills

Analytical skills

Organizational skills

Problem-resolution

Google apps

Slack

Education

College degree

CPC certification

Tools

Google Workspace

Slack

Job description

Responsibilities

• Provide effective and timely customer service for members, providers, insurers, and clients regarding health care claims
• Negotiate with providers on plan member balances and appeal claim denials from insurance companies
• Organize health insurance paperwork and medical record documentation
• Communicate timely status updates to patients throughout the claims process
• Assist members with understanding explanation of benefits (EOBs) and resolving claim errors or denials
• Contact providers and insurance companies to resolve claim concerns
• Collaborate with peers and management across functions to meet evolving business requirements

Requirements

• 1 year of experience in customer service roles
• 3 years of revenue cycle or carrier experience
• Prior work experience in a claims support and health insurance role
• Excellent written and verbal communication skills
• Strong analytical, organizational, and problem-resolution skills
• Ability to handle a fast-paced, dynamic environment with competing priorities
• Proficiency with Google apps, Slack, and other required technology

Preferred Qualifications

• Medical billing/coding certification (CPC)
• College degree