Claims Specialist

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team

2025:

• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2024:

• Excellence in Customer Service Awards: Organization of the Year (Small)
• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

As part of Teleperformance in the US, we were also named #95 in the 2024 'Fortune 100 Best Companies to Work For' in the USA by Great Places to Work (GPTW)

HA CLAIMS SPECIALIST

Join Us as a Claims Resolution Champion

At Health Advocate, we're on a mission to simplify healthcare and empower our members to navigate their benefits confidently. If you're ready to make a meaningful impact by resolving complex claims and advocating for those who need support, this is your chance to transform lives.

As a Claims Specialist, you'll go beyond solving billing issues—you'll serve as an advocate, educator, and problem-solver for our members. By leveraging your expertise in claims, benefits, and coordination of care, you'll ensure timely resolutions that ease stress and deliver value. In this role, you'll join a team that values collaboration, precision, and compassion.

What You'll Do: Advocate, Resolve, Educate

This role is more than answering questions—it's about being a trusted guide for our members. Here's how you'll make an impact:

• Resolve Complex Claims Issues: Investigate billing discrepancies, identify errors, and coordinate resolutions among members, carriers, and providers for timely claim processing.
• Coordinate Benefits Across Carriers: Manage cases involving Medicaid, Medicare, motor vehicle claims, and other benefit programs, ensuring proper coordination.
• Educate and Empower Members: Help members understand their benefit plans, educate them on coverage details, and guide them through challenging claims scenarios.
• Ensure Accuracy: Adhere to internal policies, procedures, and federal regulations to process claims in a precise and timely manner.
• Collaborate and Escalate: Partner with team members and escalate unresolved issues to supervisors or carriers when necessary.
• Support Team Growth: Mentor new team members, share best practices, and contribute to continuous process improvements.

Who You Are: A Detail-Oriented Advocate

We're looking for someone who's passionate about helping others, thrives on solving challenges, and brings technical expertise to the table.

• Experienced Professional: You have at least 2 years of experience in healthcare, customer service, or claims.
• Problem-Solver: You excel at analyzing claims, identifying root causes, and proposing practical solutions.
• Empathetic Communicator: You possess strong listening skills and the ability to guide members with care and patience, even in complex or emotionally charged situations.

• Knowledgeable and Resourceful: Familiarity with plan documents, ACA guidelines, Medicare, COBRA, and benefits such as dental, vision, and behavioral health is a plus.

• Tech-Savvy: You're proficient in MS Word and Excel and comfortable using internal databases to document and track cases.

Why Health Advocate?

At Health Advocate, we don't just resolve claims—we build trust and provide peace of mind. Here's what you'll gain by joining us:

• Purpose-Driven Work: Be a key player in simplifying healthcare for members and making a real difference in their lives.
• Tools for Success: Access advanced systems, comprehensive training, and the support of a collaborative team.
• Comprehensive Benefits: Enjoy competitive pay, robust medical, dental, and vision coverage, 401(k) with company match, PTO, and more.
• A Culture of Care: Join a team that values empathy, innovation, and teamwork.

Your Next Move

Ready to transform challenges into resolutions and make healthcare easier for those we serve? Apply today and take the first step toward a rewarding career with Health Advocate

Company Overview

Health Advocate is the nation's leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.

Learn more

Health Advocate

Awards:

2025:

• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2024:

• Excellence in Customer Service Awards: Organization of the Year (Small)
• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2023:

• National Customer Service Association All-Stars Award: Service Organization of the Year.
• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2022:

• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
• Excellence in Customer Service Awards: Organization of the Year (Small)
• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2021:

• Stevie Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Silver Winner
• Stevie Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner
• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2020:

• National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up
• Communicator Award of Distinction: October 2019 Broker News
• MarCom Awards: Gold, COVID Staycation Ideas brochure
• MarCom Awards: Platinum, 2021 Well-being Calendar
• Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver)

Physical Requirements:

This position is primarily on-site and requires the ability to move throughout the workplace to provide in-person counseling and wellness support. The role involves periods of sitting for one-on-one or group sessions, as well as standing or light movement during group activities, workshops, and team-building events. Essential physical functions include speaking, hearing, and manual dexterity for documenting case notes, navigating computer systems, and facilitating wellness interventions. Occasional lifting of light materials (up to 15 pounds) may be needed for wellness activities or event setup. Frequent use of a computer is required, including typing, mouse navigation, and viewing digital content. Visual acuity is necessary for reading client records, electronic documentation, and conducting virtual sessions when needed.

Mental and Cognitive Requirements:

The role requires strong emotional resilience, active listening, and the ability to assess and respond to sensitive mental health concerns. Counselors must exercise sound clinical judgment in crisis situations, maintain professional boundaries, and uphold confidentiality. The ability to develop therapeutic rapport, apply evidence-based interventions, and manage documentation with accuracy is essential. The role also requires facilitation skills for group sessions and the ability to consult with leadership.

Work Environment:

This position is fully on-site and embedded within the Trust and Safety operational environment. The counselor must be comfortable working in a dynamic and fast-paced setting that may include exposure to discussions of distressing content. The workspace includes a private, designated office for confidential counseling and group programming, with access to standard office equipment and secure data systems.

VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans.

PAY TRANSPARENCY NONDISCRIMINATION PROVISION

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-I.35(c)