Job Description

Member Services Patient Advocate

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple – we strive  to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external – driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY

Are you looking for a rewarding new position with an industry leader with a firm commitment to its employees? Join our team at Claritev! Founded in 1980, we are the industry’s most comprehensive provider of healthcare cost management solutions. We have almost 1,000,000 healthcare providers under contract, an estimated 70 million consumers accessing our network products, and 46 million claims reduced through our network and non-network solutions each year. This position may be located anywhere in the Eastern, Central, Mountain or Pacific time zones. Work schedules are as follows:

• 7:00 am to 5:00 pm PT
• 8:00 am to 6:00 pm MT
• 9:00 am to 7:00 pm CT
• 10:00 am to 8:00 pm ET

DUTIES

As a Member Services Patient Advocate, you will be responsible for addressing all member communications related to balance billing situations, educating of the process, and updating on the negotiations for closing out the balance bills.

Your specific duties in this role will include:

1. Manages member phone line and answers all inquiries.
2. Ensures member inquiries are addressed timely; including education.
3. Ensures clear documentation of events associated to a medical claim.
4. Manages a daily running inventory of claims, prioritizing one’s work schedule accordingly.
5. Addresses all member emails, incoming calls, texts and inquiries.
6. Maintains daily tasks of sending letters to members and recording contact information.
7. Keeps the Lead Patient Advocate direct report informed of critical matters.
8. Collaborates, coordinates, and communicates across disciplines and departments.
9. Assists in maintaining a clean, safe and unobstructed workplace environment.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate commitment to the Company’s core values.
12. Please note due to the exposure of PHI sensitive data — this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE :
This position works under direct supervision in a self-directed and results oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge gained through training and experience to complete the job responsibilities as assigned. Work may often be varied and complex in nature. The incumbent may have regular contact amongst all levels of internal and external sources to complete objects keeping the needs of external and internal customers in mind when making decisions and taking action.

COMPENSATION

The salary range for this position is $20 to $24 per hour. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

REQUIREMENTS

Specific qualifications for the role include:

* Minimum High School Diploma
* Experience in a medical healthcare claims role dealing with facilities, providers and members
* Background in healthcare claims management and the ability to interpret benefit plans/Explanation of Benefits
* Proactive, self-starter
* Ability to manage high call volume
* Experienced and highly skilled in working with phone inquiries.
* Possesses exceptional multi-tasking and strong communication skills, both oral and written.
* A high level of professionalism, organization and flexibility.
* Detail focused
* Self-Motivating personality and a professional demeanor that promotes a team environment.
* Manages self and time so as to meet provided timeframes and deadlines, becoming flexible when necessary
* Able to work comfortably in a fast-paced environment
* Bilingual preferred
* Excellent organizational skills demonstrating strong attention to detail.
* PC literate, including Microsoft Office products and web-based applications
* Required licensures, professional certifications, and/or Board certifications as applicable
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
* Regular, timely attendance

BENEFITS

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• Paid Parental Leave
• 401(k) + match
• Employee Stock Purchase Plan
• Generous Paid Time Off – accrued based on years of service
  • WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
• 10 paid company holidays
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

EEO STATEMENT

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please  click here .

APPLICATION DEADLINE

We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.

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