Healthcare Advocate
Description
Company Overview
Goodroot is a community of companies committed to delivering more access to better healthcare at a lower cost. With a growing group of brands including, but not limited to Navion and Penstock, Goodroot is reshaping healthcare for good, one system at a time. Goodroot is an equal opportunity employer. Learn more at Goodroot - Reinventing Healthcare. Emry, an affiliate of Goodroot, transforms the healthcare experience through smart, proactive cost navigation. We help individuals and employers get the most value out of their healthcare by removing confusion, reducing costs, and improving outcomes.
Emry Concierge provides white-glove healthcare navigation for high-net-worth individuals and their families. With highly personalized service, Emry Concierge guides clients through every step of the healthcare journey—ensuring fast access to quality care, minimizing stress, and optimizing outcomes.
Role and Responsibilities
The Healthcare Advocate at Emry Concierge acts as an advisor who combines experience in health insurance and medical billing with business skills and a passion for strong customer service. The Advocate’s goal is to simplify healthcare for clients, helping them save time and money. Advocates work for a dedicated set of high-net-worth private families and corporate executive clients by managing their insurance carrier and health provider interactions. On an ongoing basis, Advocates manage insurance, billing, claims, Rx and healthcare navigation issues helping clients realize more value from healthcare.
- Building ongoing advisory relationships with clients and their assistants.
- Strong understanding of insurance plan benefits and insurance requirements.
- Providing ongoing guidance for clients to navigate healthcare and make better decisions.
- Reviewing and analyzing bills and EOBs for issues and assisting in resolution.
- Researching and resolving coverage, billing, and Rx issues with insurance carriers and providers.
- Negotiating bills with healthcare providers using our proprietary negotiation methodology.
- Filing claims for clients and tracking ongoing billing activity in proprietary software.
- Assisting with treatment pre-authorization and insurance carrier appeals for coverage.
- Researching in-network providers, comparing pricing, and recommending options.
- Managing multiple cases concurrently using our case management system.
- Providing proactive client service, including updating clients on progress and outcomes.
Requirements
Qualifications and Education Experience
- Bachelor’s degree in healthcare administration, Business, Public Health, or a related field (or equivalent experience).
- Ideal position for healthcare/insurance advocate, account manager for insurance broker, billing/revenue cycle manager for provider groups, client service manager for health insurer.
- Experience with employee benefits, health insurance, medical billing and claims.
- Professional, consultative, passion for strong client service, self-directed.
- Ability to work independently while collaborating effectively within the team.
- Strong organizational and time-management skills with the ability to manage multiple cases simultaneously
- Organized, analytical, strong attention to detail, creative problem solver.
- Excellent oral and written communication skills with the ability to explain and advise clients.
- Able to influence and negotiate with providers and insurers to achieve desired outcomes.
- Strong ability to work in a fast-paced, high-demand environment where multiple complex client needs are all high priority and require timely resolution
- High level of empathy, discretion, and professionalism when handling sensitive information
Preferred
- Health insurance producer license and/or Medicare certification, with experience.
- Medical billing/coding certification.
- Proficiency in Microsoft applications, with the ability to multitask across multiple platforms and applications simultaneously.
- Bilingual preferred