IFP Customer Service Advocate - National Remote

About the position Responsibilities • Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)) • Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems • Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member • Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits) • Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates) • Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding • Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance Requirements • High School Diploma / GED OR equivalent work experience • Must be 18 years of age OR older • 2+ years of customer service experience • Ability to work full-time, Monday - Friday between 7:00am - 6:00pm CST including the flexibility to work occasional overtime given the business need Nice-to-haves • Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design) • Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations) • Sales or account management experience • Bilingual fluency in English and Spanish Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job Apply To this Job