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Sun Life — штаб-пәтері Канаданың Торонто қаласында орналасқан жаһандық қаржылық қызметтер компаниясы. 1865 жылы құрылған компания жеке тұлғаларға, бизнеске және ұйымдарға сақтандыру, инвестициялау, қаржылық кеңес беру, әл-ауқатты басқару, денсаулық сақтау және активтерді басқару шешімдерін ұсынады. Sun Life Солтүстік Америкада, Азияда және Еуропада жұмыс істейді, қаржылық қызметтерді денсаулыққа бағытталған ұсыныстармен ұштастыра отырып, тұрақтылыққа, әртүрлілік пен инклюзияға және қоғамға әсер етуге басымдық береді. Оның ауқымды қызметі қаржы, денсаулық сақтау, консалтинг және онымен байланысты қызметтер салаларында жұмыс істейтін командаларды қолдайды.
Billing Advocate Associate – Baltimore Hybrid
Support Sun Life members by resolving medical billing and insurance claim issues in a hybrid Baltimore role. Handle appeals, audits, claims coordination, and complex member advocacy from investigation through resolution.
Сипаттама
- Investigate unpaid, underpaid, and denied claims, using follow-up, escalation, and appeals to pursue resolution.
- Review medical bills, Explanations of Benefits, and payment records for accuracy.
- Manage out-of-network claim submissions and flag coding, processing, or coverage discrepancies.
- Lower members’ out-of-pocket expenses through corrected claims and coordination of benefits.
- Facilitate communication and resolution among members, healthcare providers, and insurers.
- Record claim work, member interactions, and recommendations in Salesforce.
- Use Microsoft Office, PDF and document-management applications, and carrier portals and call systems.
- Provide support across Insurance Claims Advocacy products and handle escalations involving complex cases.
- Coach new employees and support onboarding and cross-training activities.
- Complete recurring case reviews to strengthen skills and maintain policy compliance.
- Help create, assess, and improve standard operating procedures.
- Assist with collecting and analyzing performance metrics.
- Work with colleagues to identify process gaps and implement improvements.
- Calm client concerns and develop appropriate resolutions.
Талаптар
- Experience with health insurance, medical billing, or insurance advocacy.
- Strong knowledge of medical billing audits, appeals, and coordination of benefits.
- Outstanding verbal, written, and interpersonal communication abilities.
- Highly organized, able to prioritize effectively, and capable of managing multiple member cases at once.
- Proficiency with Microsoft Office.
- Experience using Adobe or comparable document-management software.
- Familiarity with insurance carrier and plan portals.
- Salesforce experience is preferred.
- Ability to approach sensitive situations with diplomacy, persistence, and sound judgment.
- Collaborative work style supported by strong work ethic, perseverance, and initiative.
- Consistent focus on member needs.
- Basic familiarity with CPT, HCPCS, and ICD medical coding.
Артықшылықтар
- Generous vacation and sick leave.
- Paid family, parental, and adoption leave.
- Medical coverage.
- Company-paid life and accidental death and dismemberment insurance.
- Disability programs.
- Partially paid sabbatical program.
- 401(k) employer matching.
- Stock purchase opportunities.
- Employer-funded retirement account.
- Flexible, inclusive, and collaborative workplace.
- Support for career development and advancement.
- Discretionary annual incentive award tied to individual and business performance.
Ұқсас жұмыс орындары
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