Overview

As a Healthcare Network Services Advocate, you will respond to in- and out-of-network provider questions and deliver first call resolution by researching plan, eligibility, and authorization information and providing education on Explanation of Benefits. Hiring for multiple positions!

Location: 100% RemoteStart Date: Monday, January 20th 2025 Starting Pay: $17.50 / hour + monthly bonus incentives.

Training & Nesting Period: 4 to 6 Weeks

Training & Nesting Hours – Monday – Friday 8:00am - 4:30pm EST

Shift After Training – Monday – Friday 9:30am – 6:00pm EST

Responsibilities

In this Job you will:

• Research, resolve, and document approximately 30-35 inbound calls per day from providers.
• Respond to provider inquiries on claim status (payment, denials, rejections, appeals, recoupments).
• Analyze claims to ensure processing guidelines have been followed correctly.
• Track claim detail errors and escalate as needed.

This job is for you if:

• You enjoy working in a high-volume call center environment.
• You can gain/build instant rapport with people over the phone.
• You can demonstrate empathy and the patience to deal with difficult callers or complex requests.
• You are detail-oriented and able to problem solve.
• You can comply with all company policies, including HIPAA/PHI policy.
• You strive to meet/exceed individual performance goals in the areas of: Call Quality, Adherence, Attendance and other Contact Center objectives.
• You are fun to work with! We are looking for team members who bring joy to the work they do.

Qualifications

You should apply if you have:

• A High School Diploma or GED.
• Minimum 1 year Customer Service experience in a call center environment.
• Minimum 1 year work experience in the Healthcare or Medical Services with medical terminology.
• Ability to navigate dual monitors and multiple applications.
• Intermediate keyboarding abilities (at least 30 WPM, data entry while active listening).
• Basic PC & Search Engine abilities (for example: use the mouse to click, troubleshooting, working with Microsoft Office, opening a browser, using a search engine, bookmarking a site, and navigating the use of back/forward buttons).

What we offer:

• Starting Pay for external hires is $17.50 / hour + Incentive Bonus Opportunity. The pay range included in this posting reflects future growth / earning potential.
• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
• Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
• Advancement Opportunities, professional skills training, and tuition /exam reimbursement
• PayActiv - access earned income in between paychecks
• Walgreens Discount - receive up to 25% off eligible items
• Great culture with a sense of community

CareCentrix maintains a Drug Free Workplace.

#IDCC

We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

CareCentrix accepts applications on an ongoing basis until a candidate is identified.