Member Services Advocate

Imagine360, LLC; United States; Remote; USD 42,000 - 68,000; Full time

Benefits offered by this job

Multiple Health plan options

Company paid premiums for disability &

Parental Leave Policy

20 days PTO to start

10 paid holidays

Tuition reimbursement

401k company contribution

Life insurance

Job summary

Imagine360 is seeking a Member Services Advocate to join the team. The Advocate provides specialized case management, advocacy, and education to members while guiding them through the balance bill defense process.

You will collaborate with Client Services, our legal team, and external stakeholders to resolve issues and ensure a positive member experience, with strong HIPAA knowledge and high-touch service.

Qualifications

• High School Diploma or GED required.
• Bachelor's Degree required.
• Experience delivering client-focused solutions based on customer needs.
• Experience in billing, insurance, healthcare or legal environments a plus.

Responsibilities

• Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.
• Apply independent critical thinking to assist members with balance bill issues and inquiries while guiding a positive experience.
• Coordinate elevated internal and external issue resolution and act as point person for member inquiries and concerns.
• Facilitate communication with members, clients, medical providers, and external legal representation.
• Establish strong rapport with members and internal counterparts.
• Track status and resolution of member inquiries and issues and maintain documentation.
• Collaborate with internal stakeholders to address service issues and process improvements.
• Apply strong knowledge of HIPAA regulations.

Skills

Microsoft Outlook

Microsoft Word

Excel

Internet navigation

Written communication

Multi-tasking

Team collaboration

Education

High School Diploma or GED

Bachelor's Degree

Tools

Microsoft Outlook

Microsoft Word

Excel

Job description

Imagine360 is seeking a Member Services Advocate to join the team! The Member Services Advocate provides specialized case management, advocacy, and education to members while fulfilling the mission. The Advocate guides and supports the member through the balance bill defense process while working closely with Client Services, our legal team and external stakeholders to facilitate timely issue resolution and ensure a positive member experience.

Position Location:

100% remote

Responsibilities include but are not limited to:

• Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.
• Apply independent critical thinking and acumen to assist members with their balance bill issues and inquiries with a focus on influencing a positive member experience
• Handle and coordinate elevated internal and external member issue resolution with confidence and a sense of urgency. Act as point person for member inquiries, issues and concerns. Direct, quarterback and ensure timely issue resolution and remediation.
• Facilitate, influence and coordinate communication with members, clients, medical providers, in-house and external legal representation
• Establish and build a strong rapport with members and internal counterparts
• Track status and resolution of member inquiries and issues
• Maintain accurate and complete documentation and follow-up diaries during all stages of the process
• Collaborate with other internal stakeholders to address service issues and process/systemic enhancement opportunities
• Apply strong knowledge of HIPAA regulations

Required Experience/Education:

• High School Diploma or GED
• Bachelor's Degree
• Experience in delivering client-focused solutions based on customer needs
• Experience in billing, insurance, healthcare or legal environments a plus

Skills and Abilities

• Proficiency in Microsoft Outlook, Microsoft Word, Excel and internet navigation
• Ability to multi-task and thrive in a fast-paced entrepreneurial company
• Excellent written and verbal communication skills

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

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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**