Client Reimbursement Advocate - Post Service

Imagine360; United States; On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Multiple Health plan options

Company paid premiums for disability &

life insurance

Parental Leave Policy

20 days PTO to start / 10 Paid H il id

Tuition reimbursement

401k Company contribution

Company paid Short & Long term DI plus

Professional development opportunities

Diversity & inclusion initiatives

Job summary

Imagine360 is seeking a Client Reimbursement Advocate to join the team. On behalf of clients and members, you will work directly with providers to manage, negotiate, and resolve disputes to secure access to care and minimize denials.

The role emphasizes empathetic advocacy, remote work, and collaboration with internal/external partners to resolve billing issues while upholding quality standards.

Qualifications

• Bachelor's degree preferred.
• Minimum 1 year of healthcare, health insurance, or customer service experience.
• Excellent written, verbal, and listening communication.
• Experience with CMS1500/UB04 medical claim forms and medical coding is a plus.

Responsibilities

• Negotiate single case agreements with providers.
• Determine actions to settle medical claims per applicable laws (e.g., No Surprises Act).
• Monitor and maintain the negotiation queue and inventory.
• Escalate claims for management review when needed.
• Educate providers about the i360 process to secure fair access to care.

Skills

Communication

Interpersonal skills

Analytical skills

Negotiation

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Imagine360 is seeking a Client Reimbursement Advocate to join the team!

On behalf of clients and members, the Client Reimbursement Advocate works directly with providers to manage, negotiate, and resolve disputes to ensure fair and reasonable agreements on medical claims and services and to secure access to care for members. As the Client Reimbursement Advocate, your empathetic nature is essential as you advocate for members to minimize provider balance billing and denials of care.

Position Location:100% remote

Responsibilities include but are not limited to:

• Responsible for contacting providers to negotiate single case agreements
• Determine the proper course of action to settle medical claims, including following any state or federal laws (such as the No Surprises Act) as required.
• Monitor and maintain the negotiation queue and inventory
• Work with internal and external partners to help resolve billing issues.
• While meeting quality and production standards, track and document all communications that relate to the claims and settlement negotiations.
• In order to build sustainable relationships and trust with clients, adhere to guidelines, escalate claims for management review when needed, and maintain open and interactive communication with all key players.
• With exceptional customer service skills, identify and execute on opportunities to negotiate settlements with providers, contact facilities upon request to educate them regarding the i360 process, and champion on behalf of the member to ensure fair access to care at reasonable cost.

Required Experience/Education:

• Bachelor's degree preferred
• Minimum 1 year of healthcare, health insurance, or customer service experience
• Skills and Abilities:
• Excellent communication (written, verbal, and listening), interpersonal, and analytic skills
• Experience with negotiations preferred
• Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
• Experience in billing, insurance, healthcare, or legal environments is a plus!

What can Imagine360 offer you?

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation