Consumer Care Advocate

This is a fully remote position, open to applicants in North Carolina, +3 more states.

📋 Description

• Manage incoming calls, faxes, and voicemails from claimants, providers, clients, attorneys, and others.

• Address claims-related questions and concerns in accordance with established guidelines and policies.

• Relay claim status and current activity to clients and relevant medical contacts.

• Respond to inquiries specific to jurisdiction and claims.

• Input data into claims management systems.

• Ensure that claim files are thoroughly documented and that claims coding is accurate.

• Facilitate updates or changes to claimant addresses in coordination with internal departments.

• Refer cases to legal, utilization review, pharmacy, and the Special Investigations Unit (SIU) when appropriate.

• Organize independent medical examinations.

• Contribute to the organization’s quality initiatives.

• Perform additional tasks as assigned.

⛳️ Requirements

• High school diploma or GED is mandatory.

• An Associate’s degree from an accredited college or university is preferred.

• Relevant professional certification related to the line of business is preferred.

• A minimum of two (2) years of administrative and/or customer service experience or a comparable combination of education and experience is required.

• Strong oral and written communication skills are essential.

• Proficiency in PC usage, particularly with Microsoft Office applications.

• Excellent investigative and organizational abilities.

• Strong interpersonal skills.

• Capacity to work effectively in a team setting.

• Ability to meet or exceed established Performance Competencies.

• Capability to manage multiple priorities simultaneously and adhere to deadlines.

🏝️ Benefits

• Comprehensive training program.

• Personalized support and coaching.

• Continuous development and advancement opportunities.

• Inclusive benefits package promoting physical, mental, financial, and professional well-being.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• 401(k) with matching contributions.

• Paid time off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending account or health savings account.

• Additional voluntary benefits.

• Reasonable accommodations.

• Emphasis on work-life balance.

• Opportunities for both in-office and virtual work.