Note: The job is a remote job and is open to candidates in USA. Marpai Administrators is a technology company transforming the third-party administration sector for employers with self-funded health plans through AI and machine learning. The Customer Service Advocate handles member, provider, and vendor interactions, resolves eligibility, benefits, and claims issues, and provides guidance on healthcare plan services and resources.
Responsibilities
- Handle incoming interactions received from members, providers, and vendor contacts within defined service protocols
- Resolve member and provider issues concerning eligibility, benefits, and claims
- Outbound interactions with members and providers following up on a task
- Educating and counseling members and providers:
- Eligibility Information
- Benefit Information
- Pre-Certification Information
- Claim Information
- Doctor and/or Facility Network Validation
- Outbound interactions with providers to ensure Pre-Certification/Authorization is completed
- Work closely with the claims department to ensure claims are accurately processed
- Create and document CRM to precisely communicate with the members and providers
- Provide excellent verbal communication utilizing company resources
- Recommend network providers, wellness programs, and additional employer-offered benefits
- Anticipate customer needs, following up with previous customers to offer additional information and service
- Training completed 100% Online
- Other duties as assigned
Skills
- Minimum of 3 years of Customer Service experience in a call center is required
- Ability to communicate with all levels of people to illustrate superior professionalism
- Excellent written communication and documentation skills
- Ability to manage multiple projects to a successful conclusion
- Analytical ability to research and deal with situations where limited standardization exists
- Attention to detail with the ability to prioritize and meet deadlines
- Must have basic knowledge of all desktop computer applications such as MS Office including Outlook, Word, Excel, PowerPoint, and Adobe Reader
- Ability to adapt and be flexible in a variety of situations
- Ability to multitask and possess strong time management skills
- Medical terminology and/or insurance experience
- Experience in a fast pace, high call volume environment
- Fast paced, dynamic work environment requiring the ability to be adaptive, innovative and flexible
- Travel minimal
- HS Diploma, college a plus
Benefits
- Training completed 100% Online.
- Generous PTO
- Medical and Prescription
- EAP
- FSA / HSA / Dependent Care
- Dental
- Vision
- Life and Disability
- STD/LTD
- Voluntary Benefits: Critical Illness, Accident, Hospital
- 401k with Employer Match
- LegalShield
- Identity Theft Protection
- This is a remote position.
Company Overview