Provider Client AdvocatePrimary Location: Phoenix, Arizona
Additional Locations: AZ-Phoenix, FL-Jacksonville, OH-New Albany, TX-Arlington, TX-Houston Apply
- Acts as a single-point-of-contact for Medicaid CICR (claim inquiry claim research) escalated member level issues and/or broader plan administration matters, primarily via email.
- May include requests for claim analysis, benefit questions and plan clarification, verification and updates to terminations, hire/re-hire dates, and correction of enrollment errors.
- Resolves escalations and communicates resolution to the Health Plan, including action steps for long term solution, if necessary.
- Tracks and trends escalation resolution. Identifies global Health Plan specific issues and escalates to Account Manager for resolution, while staying abreast of resolution steps Participates in Health Plan conference calls to discuss member related issues or concerns and escalation trends
- Submits requests for fulfillment orders for Health Plan and members Researches and submits member level refund requests Supports installation of new and existing accounts by attending implementation planning/process meetings.
- Collaborates with Account Management team to achieve growth/renewal objectives and meet customer expectations Initiates and maintains partnerships with other departments throughout the organization.
- Encourages cooperation by promoting common goals and building trust.
- Inspires, supports, and initiates cross-functional activities Insures acknowledgement and resolution
- Performance Guarantee goals are met within the scope of the Client Advocate role
- Creates and updates specific Health Plan information in the Health Plan Tool Utilizes exceptional written communication skills during interaction with Health Plan, assuring clear, concise information is relayed and proper grammar and punctuation are used
- Possesses flexibility, workload balancing, and willingness to assist team members when backlogs occur to achieve success and meet customer expectations
- Ability to work with cross-functional business units to meet customer needs; promotes collaboration among constituents and represents a professional image of the company
- Ability to support multiple plan sponsors
- Account Management experience and/or Plan Sponsor Service experience
- 2- or 4-year college degree or equivalent work experience.
- Associate's degree or equivalent work experience.
- 3-5 years previous experience with Call Center/Claim environment is desired
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