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favorite this post Claims Associate - 125320 (Plymouth Meeting, PA) hide this posting unhide

compensation: DOE
employment type: full-time

Health Advocate is a leading provider of Advocacy and health benefits support. We have grown every year since our Launch in 2001. We continue to grow and provide health support solutions to our clients and members. Health Advocate offers a comprehensive training program and opportunities to grow your career learning multiple aspects of health benefit coverages and services.

We offer Great Benefits!

The benefits package for this position includes very generous Paid Time Off (PTO), paid holiday policy, tuition reimbursement and a 401(k) with a match. Health Advocate has an Onsite fitness facility, yoga classes, Employee Assistance Program, wellness programs, and employee activities to support employees with various goals.

Job Summary:
•A Claims Associate at Health Advocate researches and resolves medical claims questions. It’s a great role for learning a lifelong skill in understanding health benefits. This is an entry level role in which we will train you to understand Health Benefit Plans, claims processing guidelines and health coding practices
•This role is a great way to learn about medical plans and enhance your career in the health benefits field
•The role is comprised of detailed investigations in which you will look at how a medical claim should be processed and resolve it for our member if it was incorrectly adjudicated initially

Essential Job Functions:
•Handle cases in a timely manner to identify opportunities to resolve the issue by working with plan documents, carriers, providers and member
•Research plan information and identify where there may be conflicting information
•Research billing issues to determine the possible cause of the error, and assisting with claims resubmission when needed to correct the issue

Working with these resources to analyze and resolve billing issues:
•Plan documents and plan benefits
•Interpretation of benefits
•Medical, dental, vision, behavioral health billing and claims adjudication
•FSA, HRA and HSA plans

Qualifications

Education
•High School Degree or GED required
•Time spent in pursuit of a Bachelor’s degree (e.g. Junior and Senior year) may be substituted in lieu of experience requirements
•Associate degree preferred

Experience
•Minimum of three years customer service, healthcare, or claims experience required

We connect. We deliver. We are West.

Equal Opportunity Employer/Veterans/Disabled
Job: Operations
Primary Location: United States-Pennsylvania-Plymouth Meeting
Organization: Health Advocate USA
Schedule: Full-time
  • Principals only. Recruiters, please don't contact this job poster.
  • do NOT contact us with unsolicited services or offers

post id: 6893457712

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