Remote Healthcare Service Advocate

ImageNetLLC

7d•Remote

About The Position

The Customer Service Advocate is responsible for providing exceptional support to healthcare providers by handling emails, faxes, and web inquiries related to healthcare claims, appeals, and payment concerns. This role serves as the primary point of contact for providers, ensuring timely resolution of inquiries while delivering a high level of customer service and maintaining compliance with company policies and service standards. This is an Urgent Hiring! Position Summary Customer Support Handle healthcare providers regarding claims, payments, appeals, and other account-related inquiries. Respond to provider inquiries received via E-Mail, Fax, and web requests in a timely and professional manner. Provide accurate claim status updates and explain claim outcomes based on company guidelines. Resolve provider concerns by researching claim information and coordinating with internal departments when necessary. Deliver exceptional customer service while meeting established quality and productivity standards. Claims Inquiry Support Review claims requiring additional research, reprocessing, or finalization. Process faxed claims and review Explanation of Benefits (EOBs). Verify claim information and ensure requests are handled accurately. Escalate complex issues following established procedures. Appeals & Payment Support Provide status updates on provider appeals. Follow up on aging appeals and request additional information when necessary. Process requests for upheld and late submission letters. Research payment inquiries and assist with stop payment requests. Coordinate requests for check reissuance and copies of cashed check images. Review and monitor payment tracers. Administrative Support Monitor incoming emails and web requests throughout the day. Document all customer interactions accurately in the system. Maintain confidentiality and comply with HIPAA and company policies. Meet service level agreements (SLAs), quality, and productivity metrics.

Requirements

High school diploma or equivalent; college degree is an advantage.
At least 4 years of experience in healthcare contact center, provider services, or claims support environment.
Basic knowledge of healthcare claims, EOBs, appeals, and payment processes is an advantage.
Excellent analytical, multitasking, organizational, and communication skills with strong attention to detail and accuracy.
Tech-savvy, with proficiency in MS Office and online systems.
Ability to work flexible shifts, including nights, weekends, and holidays.
Must be located in or near Manila (preferred).
Can start ASAP.
Requires a stable primary internet connection of at least 50Mbps.
Reliable backup connection to ensure continuity of remote work.
Ability to directly hardwire to your modem.
Required to have a quiet dedicated work area.

Nice To Haves

College degree is an advantage.
Basic knowledge of healthcare claims, EOBs, appeals, and payment processes is an advantage.
Must be located in or near Manila (preferred).

Responsibilities

Handle healthcare providers regarding claims, payments, appeals, and other account-related inquiries.
Respond to provider inquiries received via E-Mail, Fax, and web requests in a timely and professional manner.
Provide accurate claim status updates and explain claim outcomes based on company guidelines.
Resolve provider concerns by researching claim information and coordinating with internal departments when necessary.
Deliver exceptional customer service while meeting established quality and productivity standards.
Review claims requiring additional research, reprocessing, or finalization.
Process faxed claims and review Explanation of Benefits (EOBs).
Verify claim information and ensure requests are handled accurately.
Escalate complex issues following established procedures.
Provide status updates on provider appeals.
Follow up on aging appeals and request additional information when necessary.
Process requests for upheld and late submission letters.
Research payment inquiries and assist with stop payment requests.
Coordinate requests for check reissuance and copies of cashed check images.
Review and monitor payment tracers.
Monitor incoming emails and web requests throughout the day.
Document all customer interactions accurately in the system.
Maintain confidentiality and comply with HIPAA and company policies.
Meet service level agreements (SLAs), quality, and productivity metrics.