Claims Customer Service Advocate - Remote / Telecommute

Job Title: Claims Customer Service Advocate - Remote / Telecommute

Job Location: Memphis, TN

Job Type: Contract

Pay Range: $11.75hr - $16.75hr

Job Overview:

The primary purpose of this role is to provide high quality service to both internal and external customers, delivering an easy and efficient customer experience for routine lost time.

Essential Functions and Responsibilities:

• Processes incoming calls, faxes, and voicemails from claimants, providers, clients, attorneys, and other parties, resolving their claims-related questions and issues in accordance with designed guidelines and policies.
• Communicates claims status and current claim activity with stakeholders and appropriate medical contacts; responds to inquiries about jurisdiction- and claim-specific issues.
• Enters data into claims systems and ensures claim files are properly documented and claims coding is correct.
• Coordinates claimant address updates or changes with internal departments.
• Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate, and coordinates independent medical examinations.

Additional Functions and Responsibilities:

• Performs other duties as assigned.
• Supports the organization s quality programs.

Education & Licensing:

• High school diploma or GED required.
• Associate s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Experience:

• Two (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.

Skills & Knowledge:

• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Strong investigation and organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

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• Medical, Dental, and Vision Insurance
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities