Customer Advocate Level I

MedRisk LLC; United States; On-site; USD 42,000 - 64,000; Full time

Job summary

MedRisk/SPNet is seeking a Customer Advocate to support communication between our network providers and referring adjusters and nurse case managers in a regular full-time role in the United States.

The position focuses on tracking patient progress, maintaining case integrity, and facilitating timely updates and authorizations while upholding HIPAA and URAC guidelines. Candidates should have 2–3 years of customer service and healthcare experience.

Qualifications

• Bachelor’s Degree preferred; impeccable customer service skills with 2-3 years of experience preferred.
• Healthcare experience required; minimum of 1 year preferred.
• Experience working with a US company (PH specific).
• Ability to work independently and multi task in a fast paced environment.
• Detail oriented; strong organizational skills; time management.

Responsibilities

• Level I duties include managing claims and monitoring case status, updating data in MedRisk’s platform, relaying authorizations, and ensuring HIPAA compliance.
• Level II duties include training and shadowing new hires, supporting system navigation, and handling escalated client requests.
• Level III duties include coaching peers, assisting Trainers, and improving workflow strategies.

Skills

Customer service

Attention to detail

Communication

Multi-tasking

Time management

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Outlook

Zoom

Job description

Regular Full-Time US

Position Summary

As a Customer Advocate, you will be supporting communication between MedRisk/SPNet’s network providers and referring adjusters and nurse case managers. You will report to the Customer Advocate Team Lead and/or Supervisor to help strengthen MedRisk/SPNet’s referral process, ensuring efficient workflow, while increasing customer satisfaction. Acting as liaison, the Customer Advocate tracks patient progress from the start of treatment, throughout treatment, and through to closure by obtaining relevant case updates from providers, including but not limited to dates of service, compliance, treatment notes, and continued authorization. They are responsible for maintaining the integrity of the case file and related documents and communicating professionally and effectively with the customer.

Primary Duties & Responsibilities

Level I:

• Manage claims and monitor case status by confirming patient attendance with network providers, and addressing any concerns regarding compliance
• Properly update all case related data to MedRisk’s database/platform
• Track and relay authorization to our providers as directed by the clients with confirmations to the adjuster and NCM
• Be knowledgeable regarding the client’s unique needs and respond appropriately
• Build approachable, professional relationships with providers and referring customers.
• Compliance with HIPAA and URAC guidelines
• Employee is expected to work a minimum of 60 tasks daily

Level II

• Assist with training/shadowing new hires and provide constructive feedback on their progress
• Identify additional areas of support post training
• Provide proper support within system navigation
• Assist with escalated and time sensitive client and customer requests
• Complete special projects as assigned
• Provide coaching opportunities for peers to Team Leads and Supervisors as identified

Level III:

• Provide coaching opportunities for peers to Team Leads and Supervisors, as identified
• Actively participate in assisting Trainers on workshops and training the team
• Become valued contributors within the Senior Mentor Program
• Build strategies for more efficient workflows within our systems

Qualifications

• Bachelor’s Degree preferred; impeccable customer service skills with 2-3 years of experience preferred
• Healthcare experience required; minimum of 1 year preferred
• Experience working with a US company (PH specific)
• Ability to work independently and multi task in a fast paced environment
• Detail oriented
• Basic knowledge of Microsoft Word, Excel, Outlook and Zoom
• Computer skills in Windows environment
• Time management and strong organizational skills
• Ability to receive constructive feedback