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Personal Health Advocate

AdvocateGeneralFull TimeRemoteSeniorTeam 1,001-5,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

4 days ago

Salary

0

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Personal Health Advocate

Health Advocate

• Receive calls from members in regards to various healthcare issues (e.g., infertility, disease, medication, etc.) and determine best course of action/s to assist the members while adhering to established policies, procedures, and key performance indicators (KPIs) • Build relationships with members in order to collaborate and develop plans of action by going above and beyond members’ initial requests • Assist and educate members in understanding their medical conditions, associated health testing, test result interpretation, and health options available to them • Provide members choices in medical care providers and services based on the members’ clinical needs, geographic locations and available benefit offerings • Research providers through credentialing, education checks and affiliations with notable medical centers within the member’s plan • Facilitate communication among members, treating physicians, and insurance carriers • Document cases in the department’s case management system using approved processes and procedures • Keep up-to-date on patient care procedures which include diagnosis, pre-certification, prior authorization, pre-service and post-service denials • Continuously stay up to date on various health issues and medical procedures necessary to offer top of the line feedback to members • Mentor new team members

Job Requirements

  • BSN or RN degree from an accredited college or university required
  • Minimum three to five years clinical and/or medical management experience
  • Active and unrestricted State or Multi-State RN License
  • Understanding of medical terminology to assist in locating appropriate care options
  • Strong Communication skills and phone etiquette
  • Strong ability to explain complex issues to employees/retirees
  • Highly effective listening skills
  • Strong problem solving/issues resolution skills
  • Excellent customer service and customer resolution skills
  • Organizational and administrative skills
  • Experience with Microsoft Word and Excel
  • Ability to work in a team environment

Benefits

  • Helping people every single day
  • Training provided to do jobs well
  • Supportive and friendly work environment
  • Opportunities for growth and career advancement

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