Patient Advocacy and Support Representative
5 days ago
Responsibilities:
- Advocate for patients and their families by handling incoming inquiries from healthcare providers regarding claim decisions and payments.
- Gather claim information, assess, and fulfill the callers' needs, and provide education on claim submission procedures.
- Fully resolve issues on the first call by navigating through computer systems to identify the current status of the issue.
- Adjust claims as warranted based on discussion and review of the provider's issue.
- Demonstrate excellent communication and interpersonal skills to build relationships with healthcare providers.
Requirements:
- A High School Diploma is required; 2 years of college preferred.
- Strong knowledge of CPHL products and applicable state and federal regulations.
- Ability to work effectively in a fast-paced environment.
About Us: Centers Plan for Healthy Living (CPHL) is a Managed Care Organization servicing members with Medicare and/or Medicaid. Our goal is to provide members and those involved in their care with guidance and health plan choices for healthy living.
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