Sun Life
Sun Life
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 – Hybrid, Baltimore

Support Sun Life members by resolving medical billing disputes, denied claims, and payment issues across its employee and government benefits business. Work with members, providers, and insurance carriers on claim corrections, appeals, and coverage questions.

Сипаттама

  • Investigate and resolve unpaid, underpaid, and denied claims through follow-up, escalation, and appeals
  • Review medical bills, Explanations of Benefits, and payment records for accuracy
  • Manage out-of-network claims while identifying errors, coding problems, and coverage discrepancies
  • Help lower member out-of-pocket expenses through corrected claims and coordination of benefits
  • Act as an intermediary among members, healthcare providers, and insurance carriers
  • Record claim actions, interactions, and recommendations in Salesforce
  • Use Microsoft Office, document-management and PDF tools, carrier portals, and call systems to check status and escalate issues
  • Provide advocacy support across Sun Life’s Insurance Claims Advocacy products
  • Serve as a resource and escalation contact for complex cases
  • Mentor new employees, support onboarding and cross-training, and conduct case reviews
  • Help create and improve standard operating procedures
  • Contribute to data collection and performance-metric analysis
  • Partner with colleagues to identify process gaps and implement improvements
  • De-escalate member concerns and develop appropriate resolutions

Талаптар

  • Background in health insurance, medical billing, or insurance advocacy
  • Demonstrated expertise in medical billing audits, appeals, and coordination of benefits
  • Outstanding verbal, written, and interpersonal communication abilities
  • Strong organizational and prioritization skills with the ability to manage multiple member cases concurrently
  • Proficiency with Microsoft Office applications
  • Experience with Adobe or comparable document-management software
  • Ability to work effectively with insurance carrier and plan portals
  • Salesforce experience is preferred
  • Ability to navigate sensitive situations with diplomacy and determination
  • Collaborative work style supported by strong ethics, persistence, and initiative
  • A clear 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 insurance coverage
  • Company-paid life and accidental death and dismemberment insurance
  • Disability support programs
  • Partially paid sabbatical program
  • 401(k) plan with employer matching
  • Employee stock purchase opportunities
  • Employer-funded retirement account
  • Flexible, inclusive, and collaborative workplace
  • Support for career development and advancement
  • Annual discretionary incentive opportunity based on individual and business performance

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