Temporary Benefits Claims Advocate

Job description

Job Description: Performs specialized administrative and customer service work assisting employees with health insurance claims and coverage issues. The work involves coordinating with employees, medical providers, and insurance carriers to resolve claims discrepancies, ensure proper benefits application, and support accurate claims processing. This position is temporary and project-based, created to address increased workload during a system transition. Work is performed under general supervision. Essential Job Functions: Provides direct assistance to employees by receiving, reviewing, and documenting health insurance claims issues and concerns. Conducts research and analysis of claims discrepancies, including denials, billing errors, and eligibility issues. Coordinates and participates in real-time communications between employees, medical providers, and insurance carrier representatives to resolve claims issues. Explains benefit plan provisions, including coverage rules and plan design, to ensure accurate billing and claims processing. Monitors claims through the resolution process, ensuring corrections are completed and claims are properly reprocessed. Maintains detailed record...