Health Advocate
- Medical Cost Negotiator and Claims Specialist
At a glance
Location: US-PA-Plymouth Meeting Map
Posted: 09/20/2019
Closing: 10/19/2019
Degree: 4 Year Degree
Type: Full-Time
Experience: 1 to 10 years
Job description

Position Overview 

At Health Advocate, we are committed to providing our customers with expertise and services that improve the health, well-being and productivity of their employees. We are looking for the right person to work with medical providers to negotiate balances outstanding on members claims. 

The appropriate candidate would be responsible for managing multiple claims cases, interfacing with internal staff and external providers to understand and negotiate claims balances. The appropriate candidate will follow up to ensure all aspects of the negotiation are documented and processed for member satisfaction. 

Essential Job Functions

  • Handles Member calls & cases for claims fee negotiation

  • Negotiates Consumer/Member Medical Claims with Healthcare Providers

  • Send and Acknowledge receipt of Contracts from Consumers/Members and ProvidersTracks all Settlements

  • Reports Settlement results within the system and Statistics to Management

  • Works with other Health Advocate units, including training when requested

  • Works with product development VP to refine process and improve the Consumer/Member Settlement product

  • Supports Sales & Marketing as SME, including participation in meetings with Current and Prospective Customers

  • Provide benefit and claims consultation and support when appropriate to all internal departments. 

Job requirements
  • Claims or Call center experience preferred
  • Bachelor's Degree or applicable work experience 
  • Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing
  • Assertive, self-confident, and resilient
  • Basic computer skills
  • Ability to search and identify resources through the internet
  • Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals
  • Ability to interpret Explanation of Benefits (EOBs)
  • Familiarity with various types of health insurance coverage, coordination of benefits, and UCR fees
  • Must be able to work from a paperless file.
EEO/AAP Employer-Minorities/Women/Disabled/Protected Veterans
Medical Cost Negotiator and Claims Specialist