Healthcare Advocate / Patient Care Coordinator / Resource Support Team
* Process medical claims and billing inquiries.* Provide benefit quotations and cost estimates to members.* Verify provider information, including identifying whether providers are In-Network (INN) or Out-of-Network (OON).* Assist members in understanding their healthcare coverage, benefits, and claim status.* Support healthcare advocates by providing guidance on complex cases and benefit-related questions.* Mentor and assist both new hires and tenured advocates as part of the Resource Support Team.* Help improve workflow efficiency by serving as a resource for policy, claims, and provider-related inquiries.
Experience: 6 months - 1 year
Clinical Front-Desk & Patient Experience Check-ins & Scheduling: You were the first point of contact, managing the clinic's flow. Doing this virtually means you have excellent digital etiquette, know how to handle patient anxiety remotely, and understand how to optimize a provider’s calendar to prevent scheduling bottlenecks. 2. Technical EMR Information Management Uploading Documentation to the EMR: Maintaining an accurate Electronic Medical Record (EMR) is critical for compliance and patient safety. Your experience means you understand medical data hierarchies, appreciate the importance of data privacy (HIPAA compliance), and know how to keep patient charts organized and up to date. 3. Revenue Cycle & Care Coordination (The Tough Stuff) Handling Prior Authorizations: This is one of the most complex and tedious parts of healthcare administration. Your ability to navigate insurance requirements, submit clinical justifications, and manage the approval process is a massive asset that directly impacts clinic revenue and patient care timelines. Physician & Provider Outreach: Calling physicians to verify patient info and following up on authorizations requires a high level of professional confidence and clear communication. You know how to speak
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