Consumer Care Advocate

This is a fully remote position, open to applicants in North Carolina, +1 more state.

📋 Description

• Deliver exceptional service to both internal and external customers, facilitating a seamless and efficient experience for routine lost time inquiries.

• Manage incoming communications such as calls, faxes, and voicemails from claimants, providers, clients, attorneys, and others, addressing claims-related questions and issues in accordance with established guidelines and policies.

• Inform clients and relevant medical contacts about the status of claims and current activity.

• Address inquiries regarding jurisdiction-specific and claim-specific matters.

• Input data into claims systems and ensure that claim files are correctly documented and that claims coding is accurate.

• Collaborate with internal departments to update or change claimant addresses.

• Provide referrals to legal, utilization review, pharmacy, and the Special Investigations Unit (SIU) as necessary.

• Organize independent medical examinations.

• Contribute to the organization's quality programs.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• A high school diploma or GED is mandatory.

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

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

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

• Outstanding oral and written communication skills are essential.

• Proficiency in PC usage, including Microsoft Office products.

• Strong investigative and organizational abilities.

• Effective interpersonal skills are required.

• Capability to work collaboratively in a team environment.

• Ability to meet or surpass Performance Competencies.

• Capacity to manage work-related stress.

• Ability to juggle multiple priorities simultaneously.

• Commitment to meeting deadlines.

• Proficient in computer keyboarding.

• Willingness to travel as needed.

🏝️ Benefits

• Emphasis on work-life balance.

• Supportive and caring workplace culture.

• Equal Opportunity Employer.

• Commitment to a Drug-Free Workplace.