Post Service Advocate

TEKsystems • Tempe, AZ

8d • $21 - $21 • Onsite

About The Position

The Post Service Advocate resolves healthcare benefit matters that arise after medical services or treatment, with a focus on claims processing, billing disputes, and reference-based pricing cases. The role processes appeals and ensures they are submitted within required timelines; missed deadlines may result in financial liability for the client. The advocate also helps members navigate healthcare services and works across providers and internal teams to prevent unexpected costs.

Requirements

• Knowledge of contracts and claims.
• Strong understanding of the appeals process.
• Excellent negotiation skills.
• Strong attention to detail.
• Ability to stay organized and manage multiple cases.
• Strong follow-through and ability to meet deadlines.
• Strong customer service skills.

Responsibilities

• Research and identify healthcare options for members using the care navigation platform.
• Coordinate services such as imaging, physical therapy, surgeries, and other medical services.
• Contact healthcare providers by phone, email, and fax to confirm availability, services, and requirements.
• Review medical documentation and fax clinical notes or paperwork when required.
• Work with out-of-network providers to pursue single case agreements when in-network options are unavailable.
• Navigate the back-end processing of medical insurance claims to help ensure they are handled accurately and on time.
• Act on behalf of members to negotiate and resolve balance-billing issues or disputes with healthcare providers.
• Communicate case details among health services, operations, stop-loss insurance, and finance to protect members from unexpected costs.
• Process appeals and ensure they are submitted within required timelines.

Benefits

• Medical, dental, and vision coverage, if eligible.
• Critical illness, accident, and hospital coverage, if eligible.
• 401(k) retirement plan with pre-tax and Roth post-tax contribution options, if eligible.
• Voluntary life and AD&D insurance for employees and dependents, if eligible.
• Short- and long-term disability coverage, if eligible.
• Health Spending Account (HSA), if eligible.
• Transportation benefits, if eligible.
• Employee Assistance Program, if eligible.
• Time off or leave, including PTO, vacation, or sick leave, if eligible.

What This Job Offers

• Education Level: No Education Listed