Member Services Advocate
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Imagine360
US
Summary
The Member Services Advocate manages a caseload to provide advocacy, education, and case management for members navigating the balance bill defense process. They act as the primary point of contact to coordinate issue resolution between members, clients, legal teams, and medical providers.
Job Description
Imagine360 is seeking a Member Services Advocate to join the team! The Member Services Advocate provides specialized case management, advocacy, and education to members while fulfilling the mission. The Advocate guides and supports the member through the balance bill defense process while working closely with Client Services, our legal team and external stakeholders to facilitate timely issue resolution and ensure a positive member experience.
Position Location: 100% remote
Responsibilities include but are not limited to:
- Manage assigned member caseload via high-touch advocacy model with a focus on elevating the member experience and promoting engagement.
- Apply independent critical thinking and acumen to assist members with their balance bill issues and inquiries with a focus on influencing a positive member experience
- Handle and coordinate elevated internal and external member issue resolution with confidence and a sense of urgency. Act as point person for member inquiries, issues and concerns. Direct, quarterback and ensure timely issue resolution and remediation.
- Facilitate, influence and coordinate communication with members, clients, medical providers, in-house and external legal representation
- Establish and build a strong rapport with members and internal counterparts
- Track status and resolution of member inquiries and issues
- Maintain accurate and complete documentation and follow-up diaries during all stages of the process
- Collaborate with other internal stakeholders to address service issues and process/systemic enhancement opportunities
- Apply strong knowledge of HIPAA regulations
Required Experience/Education:
- High School Diploma or GED
- Bachelor's Degree
- Experience in delivering client-focused solutions based on customer needs
- Experience in billing, insurance, healthcare or legal environments a plus
Skills and Abilities
- Proficiency in Microsoft Outlook, Microsoft Word, Excel and internet navigation
- Ability to multi-task and thrive in a fast-paced entrepreneurial company
- Excellent written and verbal communication skills
What can Imagine360 offer you?
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**
Imagine360 is an integrated health plan addressing one of the greatest challenges on behalf of self-funded employers: healthcare costs are harming the bottom line, they're increasingly unaffordable for employees, and the experience remains poor. We help businesses and their employees navigate through clutter and chaos and bring deep cost savings that protect everyone’s well-being and budgets. It’s way more than a health plan. It’s a promise.
We’ve helped hundreds of self-funded clients. Our solutions are ready to be implemented. The results are proven and impactful.
Imagine360’s innovative payment model includes preferential contracting with providers and health systems, and additional price protection through reference-based pricing, saving employers 15-30% on average compared to the national carriers.
With more than 17 years’ experience, and 25-million-months of member data, Imagine360 offers care coordination and medical management to proactively guide members through the complexities of healthcare. We bring employers a reimagined health plan solution, created to provide the flexibility, service and support employers need to take good care of employees, their families and business. We do this through:
- Assistance with plan design and expert administration with integrated third-party administration
- Built-in price protection from the #1 reference-based pricing solution in healthcare
- Provider contracts with Imagine Health’s top-rated providers and health systems
- Comprehensive member support throughout their healthcare journey
It’s more than a health plan. It’s our promise to deliver a better health plan experience.
Learn more at https://www.imagine360 today!
Founded
2003
Company size
1,001-5,000 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Wayne, Pennsylvania
Imagine360 is an integrated health plan addressing one of the greatest challenges on behalf of self-funded employers: healthcare costs are harming the bottom line, they're increasingly unaffordable for employees, and the experience remains poor. We help businesses and their employees navigate through clutter and chaos and bring deep cost savings that protect everyone’s well-being and budgets. It’s way more than a health plan. It’s a promise.
We’ve helped hundreds of self-funded clients. Our solutions are ready to be implemented. The results are proven and impactful.
Imagine360’s innovative payment model includes preferential contracting with providers and health systems, and additional price protection through reference-based pricing, saving employers 15-30% on average compared to the national carriers.
With more than 17 years’ experience, and 25-million-months of member data, Imagine360 offers care coordination and medical management to proactively guide members through the complexities of healthcare. We bring employers a reimagined health plan solution, created to provide the flexibility, service and support employers need to take good care of employees, their families and business. We do this through:
- Assistance with plan design and expert administration with integrated third-party administration
- Built-in price protection from the #1 reference-based pricing solution in healthcare
- Provider contracts with Imagine Health’s top-rated providers and health systems
- Comprehensive member support throughout their healthcare journey
It’s more than a health plan. It’s our promise to deliver a better health plan experience.
Learn more at https://www.imagine360 today!
Founded
2003
Company size
1,001-5,000 employees
Industry
Insurance
Org type
Privately Held
Headquarters
Wayne, Pennsylvania