Claims Service Advocate (SAT) (Remote)
About the position Responsibilities • Utilizes various systems and process guidelines to review, process, and adjudicate moderately complex claims, ensuring quality, accuracy, and timeliness standards are met. • Reviews moderately complex claim inquiries by analyzing, interpreting, and researching the request to determine appropriate action. • Responds to incoming reports, medical records, and other related documents to make claim determinations for additional processing. • Provides information, guidance, and education to members and customers in complex and escalated situations while working in close partnership with other internal departments to ensure customer satisfaction. • Conducts research on behalf of members, providers, and customers, which may include the review of documents, statements, and information supplied by other outside agencies. • Handles incoming and outgoing customer service calls in a clear and concise manner. • Performs work under general supervision. Handles moderately complex issues and refers complex issues to higher-level staff. Requirements • High School Diploma/GED • 3 years of Customer service, Claims Processing or related experience • Ability to resolve problems, make suggestions and implement process improvements • Pays close attention to the details of all work and strives for a high level of accuracy • Responds quickly to change and easily considers new approaches • Makes customers/clients' needs a primary focus of attention • Demonstrates active listening in contacts with others • Ability to communicate verbally or in writing with individuals and groups to deliver or exchange information Benefits • Affordable medical, dental and vision coverage accepted throughout the United States • Employer funded Lifestyle Spending Accounts, Health Savings Accounts and Health Reimbursement Arrangements • Employer-paid life and disability insurance • 401(k) retirement plan with company match and immediate vesting • Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave • Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance • Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ • Comprehensive learning and development opportunities and an Educational Assistance Program • 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours • Employee recognition, community initiative events and yearly company outings • Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments • Opportunities to connect through employee committees Apply tot his job