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“Health Advocate” Company Details
| Company Name | Health Advocate |
| Rating | 2.7 / 5.0 |
| Job Type | Full-time |
| Job Position | Remote Position |
Healthcare Claims – Service Operations Supervisor Job Overview
What to do in Health Advocate company Job
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!
2023 Awards:
- 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
BASIC FUNCTION
Responsible for overseeing the daily tasks and workflow of assigned team of associates/ specialists by providing direction and structure and aiding to answer questions using knowledge of services and benefits to help guide employees and perform necessary on the job training.
Job Responsibilities:
- Responsible for the administrative functions and supervision of an operations unit. This includes backlog and quality management for a team of Operations/Customer Service associates
- Provide organization, direction and staffing for all assigned service calls and case load assignments to ensure all calls are answered in accordance with Health Advocate’s policies and procedures.
- Monitor calls and audit case files daily to ensure the proper target resolution is identified and that, if possible, the case is closed at or near the target resolution.
- Ensure assigned staff members meet or exceed the standards, results, and responsibilities of their respective positions.
- Coach, mentor, and evaluate the performance of an assigned team.
- Assist in the selection, counseling, and discipline of all staff on the team.
- Provide oversight and direction to staff for assigned cases.
- Responsible for problem-solving issues and coordinating efforts with internal departments and subject matter experts.
- Provide healthcare benefit and claims consultation and support when appropriate to all internal departments.
- Routinely evaluate and monitor service calls and case management procedures to recommend any necessary changes to the Operations Manager.
Escalate cases through the appropriate channels in accordance with Health Advocate’s policies and procedures.
Team Interfaces/Customer Service – Establish and maintain a professional relationship with internal/external customers, team members and department contacts
- Cooperate with team members to meet goals or to complete tasks
- Provide quality customer service that exceeds customer expectations and improves level of service being provided
- Treat all internal/external customers, team members, and department contacts with dignity/respect
- Escalate to supervisor any situation outside the employee’s control that could adversely impact the services being provided
- Mental and Physical Requirements
- This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers
- The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
- Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
- Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day
- Related Duties as Assigned –
- The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
- Consequently, job incumbents may be asked to perform other duties as required
- Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
- Please contact your local Employee Relations representative to request a review of any such accommodations
Minimum Qualifications
- Call center experience preferred
- Management or supervisory experience in healthcare benefits or claims processing preferred
- Strong leadership skills and the ability to build effective teams
- Effective communication skills to interact with members, physicians, and insurance carrier representatives, with an emphasis on ability to communicate both verbally and in writing
- Assertive, self-confident, and resilient
- Basic computer skills
- Ability to search and identify resources through the internet
- Demonstrated ability to communicate concepts, strategies and plans in terminology understood by business professionals
Education
- Bachelor’s Degree or applicable work experience
Other
- Basic knowledge of MS Word and Excel required
- Must score acceptably on job related testing
- Ability to pass standardized interview
- Based on assignment may need to be bilingual in English, Spanish, etc.
- Knowledge of the following is preferred:
- COBRA
- Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans
- High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)
- Flex Spending Accounts (FSA) , including limited FSAs
- Coordination of benefits and which plan is primary – simple cases (commercial plans, Medicare plans)
- Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)
- Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP
- Group Health Plans (fully insured and self-insured)
- Pharmacy benefits including injectable medications
- Individual Health Plans and Marketplace/Exchanges plans
A successful incumbent in the job will be able to demonstrate the following skills and abilities:
- Strong communication skills and phone etiquette
- Ability to explain complex issues to members
- Highly effective listening skills
- Strong problems solving/issue resolution skills
- Excellent customer service and customer resolution skills
- Strong Organizational and administrative skills
- Ability to work in a team environment
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
https://www.healthadvocate.com/site/
Awards:
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)
Health Advocate is an Equal Opportunity Employer that does not discriminate on the basis of race, color, sex, age, religion, national origin, citizenship status, military service and veteran status, physical or mental disability, or any other factor not related to job requirements. We respect and value diversity, and are committed to the principles of Equal Employment Opportunity.
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)
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