Advocate

This is your chance to take your customer service career to the next level. At ClaimDOC, we’re changing the way health care works for the better, and we want individuals who are innovative and motivated like you to join our team! You’ll find unrivaled support, as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us.

As a Member Advocate, you’ll compassionately deliver an exceptional experience to every caller, always remembering that there is a real person on the other end of the phone who is looking for help, guidance, and support.

Both of these are opportunities for you to identify and exceed our customer expectations by committing to and building strong relationships internally and externally.

This position is full-time Monday through Friday. ClaimDOC is open from 7 : 00 AM to 6 : 00 PM.

Bi-lingual candidates are strongly encouraged to apply.

Primary Responsibilities :

• Answer incoming phone calls from members covered by our client company health benefit plans and identify the type of assistance the customer needs, including accessing a provider or scheduling a procedure, interpreting an EOB or understanding an invoice received from a medical provider
• Use pertinent data and facts to identify and solve a range of problems within area of expertise
• Investigate non-standard requests and problems, with some assistance from others
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Intervene with care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed
• Assist and educate providers about the client benefit plan, including contracting opportunities with our company on behalf of the client
• Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
• Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
• Meet the performance goals established for the position in the areas of : efficiency, call quality, provider satisfaction, first call resolution and attendance.

Qualifications :

• One year of customer service representative experience or one year of experience in an office setting, with phone support experience preferred, but not required
• Strong verbal and written communication skills, including the ability to write notes and convey messages using proper grammar and punctuation.
• Experience in a setting involving health care benefits, insurance claims processing, or medical provider billing preferred but not required
• An education level of at least a high school diploma or GED
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled.

This is a full-time, on-site position. We offer competitive pay and benefits including medical, dental, vision, and life insurance.

We also offer an FSA and 401k. You will earn paid time off and paid holidays. All Member Advocates are also eligible for monthly, performance-driven bonuses.

ClaimDOC is a rapidly growing company in West Des Moines striving to change the way health care works for the better. You’ll find unrivaled support and a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Last updated : 2024-04-28