Patient Intake Advocate

Patient Intake Advocate

JOB SUMMARY: This role is responsible for addressing member, client and provider inquiries (balance bills and appeals) with an emphasis on educating members of the Patient Advocacy Center process.

As a Patient Intake Advocate, you will be responsible for matching the daily volume of incoming client claims to the correct provider using an in-house web-based application. This position may be located anywhere in the Eastern, Central, Mountain or Pacific time zones. Work schedules are as follows:

• 8:00 am to 5:00 pm PT
• 9:00 am to 6:00 pm MT
• 10:00 am to 7:00 pm CT
• 11:00 am to 8:00 pm ET

JOB ROLES AND RESPONSIBILITIES:

1. Manages main phone line and answers all inquiries.

2. Ensures member inquiries are addressed timely; including education.

3. Ensures clear documentation of events associated to a medical claim.

4. Manages a daily running inventory of claims, prioritizing one's work schedule accordingly.

5. Addresses all emails, incoming calls and inquiries while directing specific inquiries to the appropriate parties.

6. Receives, reviews and forward incoming mail.

7. Maintains daily tasks of sending letters to members, recording contact information and requesting necessary documents from clients when needed.

8. Keeps the Lead Patient Advocate informed of critical matters.

9. Assists in maintaining a clean, safe and unobstructed workplace environment.

10. Ensure compliance with HIPPA regulations and requirements.

11. Demonstrate commitment to the Company's core values.

12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High-Risk Role.

13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE:

This position works under direct supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through training and experience to complete the job responsibilities as assigned. Work may often be varied and complex in nature. The incumbent may have regular contact amongst all levels of internal and external sources to complete objects keeping the needs of external and internal customers in mind when making decisions and taking action.

JOB REQUIREMENTS (Education, Experience, and Training):

1. Minimum High School Diploma and one (1) year relevant experience.
2. Experience in a medical healthcare claims role dealing with facilities, providers and members
3. Background in healthcare claims management and the ability to interpret benefit plans/Explanation of Benefits
4. Proactive, self-starter
5. Ability to manage high call volume
6. Experienced and highly skilled in working with phone inquiries.
7. Possesses exceptional multi-tasking and strong communication skills, both oral and written.
8. A high level of professionalism, organization and flexibility.
9. Excellent organizational skills demonstrate strong attention to detail.
10. PC literate, including Microsoft Office products and web-based applications
11. Required licensures, professional certifications, and/or Board certifications as applicable
12. Individuals in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
13. Regular, timely attendance

COMPENSATION:

The salary for this position is $18.25 per hour. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

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Why Claritev?

Healthcare is complex. We help make it clearer.

At Claritev, you'll do work that matters. Together, we're helping make healthcare more transparent and affordable for all through the power of data, technology, and expertise. We offer meaningful opportunities to grow your career, collaborate with talented colleagues, and make an impact on the clients and communities we serve. If you're looking for purpose, growth, and a team that succeeds together, you'll find it here.

What Guides Us

At Claritev, innovation, agility, and a focus on results drive our success. We embrace bold thinking, work as one team, take ownership, and strive for excellence in everything we do - creating meaningful impact for our clients, communities, and each other.