Performant Financial Corporation Hiring for Healthcare Member Advocate at Remote Full Time

Healthcare Member Advocates are the primary points of contact for health plan members and Nursing Staff. They speak with members and connect them to nurses by conducting outreach calls and routing inbound calls.

Essential duties:

• Make outbound calls to members, perform necessary validation and documentation of contacts

• Schedule follow up times for additional contact by a nurse.

• Take inbound calls, answer questions regarding the program, document communication

• Develop professional working relationships with colleagues, healthcare providers and other contractors

• Conduct critical due diligence follow-ups if additional research or action is required to resolve a call

• Enter and update all contact and activity information into system e.g., a telephone call is made, recorded, and attached to the case file in the system

• Notify management of:

• displeasure or escalated concerns with the program

• legal action

• government intervention

• suggestions to improve or correct processes or documents

• Communicate with other staff/departments as necessary

• Maintain a current knowledge of campaign regulations, policies and procedures

• Maintain current knowledge of all contract requirements and objectives

• Maintain HIPAA Certification

• Perform miscellaneous duties as assigned in a highly professional manner

• Excellent verbal and written communication skills

• Bi-Lingual English and Spanish is preferred and may be required for some positions

• Skilled in data entry and knowledge of computers

• Courteous, professional, and respectful attitude

• Strong understanding of customer service policies and processes

• Member customer service background

• Claims processing and/or billing experience

• Flexibility to handle any non-standard situations that may arise

• Must be able to multi task

• Sit/stand/ walk 8-10 hours/day

• Lift/carry/push/pull under and over 10lbs occasionally

• Keying frequency, handling, reaching, fine manipulation

Other Requirements:

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and clearances (as applicable).

Must submit to and pass pre-hire background check, as well as additional checks throughout employment.

• Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
• Must submit to and pass drug screen pre-employment (and throughout employment).
• Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.

The above statements are intended to describe the general nature and level of the work being performed by people within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job.

• 4+ years medical customer service

• 1+ years Medical claims processing, and/or billing

• Hospital billing experience preferred

• High School diploma or equivalent

Job Profile is subject to change at any time.

EEO

Performant Financial Corporation is an Equal Opportunity Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.