Client Reimbursement Advocate

Imagine360•,

1d•Remote

About The Position

Imagine360 is seeking a Client Reimbursement Advocate - PreService to join the team! On behalf of clients and members, the Client Reimbursement Advocate works directly with providers to manage, negotiate, and resolve disputes to ensure fair and reasonable agreements on medical claims and services and to secure access to care for members. As the Client Reimbursement Advocate, your empathetic nature is essential as you advocate for members to minimize provider balance billing and denials of care. This position is 100% remote.

Requirements

Minimum 1 year of healthcare, health insurance, or customer service experience
Excellent communication (written, verbal, and listening), interpersonal, and analytic skills

Nice To Haves

Bachelor's degree preferred
Experience with negotiations preferred
Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
Experience in billing, insurance, healthcare, or legal environments is a plus!

Responsibilities

Deliver specialized service over multiple channels by acting as a single point of contact, maintaining ownership of member resolution and navigating optimal care.
Manage and coordinate elevated member issue resolution with confidence and a sense of urgency.
Responsible for contacting providers to negotiate single case agreements, monitoring and maintaining their assignment queue, and working with internal and external partners to help member access to care issues.
Track and document all communications and efforts on assigned matters while meeting quality and production standards.
Contact providers to resolve access to care issues and to explain medical plan pricing metrics.
Assist members with identifying alternative provider options when resolution cannot be secured with the provider.
Adhere to guidelines, escalate challenges for management review when needed, and maintain open and interactive communication with all key players to build sustainable relationships and trust with clients.
Identify and execute on opportunities to negotiate settlements with providers.
Contact facilities upon request to educate them regarding the i360 process.
Champion on behalf of the member to ensure fair access to care at reasonable cost.

Benefits

Multiple Health plan options
Company paid employee premiums for disability and life insurance
Parental Leave Policy
20 days PTO to start
10 Paid Holidays
Tuition reimbursement
401k Company contribution
Company paid Short & Long term Disability plus Life Insurance
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company's diversity and inclusion initiatives