Claims and Benefits Advocacy Specialist

ComPsych ® Corporation is the world’s largest provider of mental health services and GuidanceResources ® for life . Fueled by a commitment to relentless innovation and a comprehensive approach to care, ComPsych provides services to more than 78,000 organizations and 163 million individuals across 200 countries. Under our GuidanceResources ® brand, our personalized and fully integrated programs include behavioral health, absence management, and wellness journeys, which empower employees to lead healthier and more productive lives, while driving organizational excellence. Visit compsych.com to find out why 40% of the Fortune 500 choose ComPsych for their mental health needs.

Job Summary

The Claims and Benefit Advocacy Specialist telephonically supports callers with claims concerns, as well as benefit and healthcare plan questions. Additionally the position will interface with internal and external resources to provide guidance and resolution to caller’s issues as well as make cross-referrals as necessary.

Primary Responsibilities

• Provides expert knowledge in the area of health and benefits claims to professionally answer incoming calls and respond to caller inquiries
• Work with scheduled appointments
• Research and resolve claims and billing issues
• Educate callers on health benefit options and programs offered by their employer
• Assist callers with eligibility and benefits coverage questions
• Interface with insurance carriers, healthcare providers
• Assist with negotiating fees with healthcare providers
• Participate in special projects as assigned
• Participate in implementation meetings
• Understands and complies with the laws and regulations relevant to the position and services
• Other duties as assigned
  
  

Job Qualifications

• 3+ years of processing health care claims for payment
• Knowledge of CPT/ICD-9 coding
• Excellent problem solving skills and sound decision making
• Ability to explain complex issues to variety of audiences
• Superior customer service and client resolution skills
• Bilingual English/Spanish a plus
• Self-starter with ability to multi-task and work autonomously
• Excellent organizational and project management skills
• Effective interpersonal and communication skill
• Must be able to sit or stand at desk for prolonged periods of time while working on a computer
  
  

Benefits And Perks

• Full benefits package, including Paid Time Off (PTO), medical, dental, vision, 401(k) with match, robust EAP, wellness program, and much more
• Competitive pay with annual increases
  
  

EEO

ComPsych celebrates diversity and is an equal opportunity employer. All applicants will be considered for employment regardless of race, color, age, genetics, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status and any other characteristic protected by federal, state or local laws. ComPsych Corporation maintains a drug free workplace.