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®)

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.

• Competitive pay range: $19 to $25/hr

• 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!

Work Environment

This position is fully remote.

To ensure compliance with HIPAA requirements and protect member privacy, employees must maintain a dedicated workspace that supports confidential conversations and secure handling of sensitive information.

Applicants must have:

• A private, HIPAA-compliant workspace where confidential member information cannot be viewed or overheard by others

• Sufficient desk space to accommodate a dual-monitor…