Imagine360 is seeking a Supervisor, Client Reimbursement Advocacy to join the team! The Supervisor, Client Reimbursement Advocacy will oversee a team that works directly with providers and members to secure access to care, ensure fair and reasonable payments, and resolve issues at any level of the process.
Position Location: 100% remote
Responsibilities include but are not limited to:
- Train Advocates in accordance with department policies and procedures to ensure successful outcomes on both pre and post service negotiations.
- Respond to issues, questions, and concerns from senior management, providers, groups, members, and the Advocacy team to ensure a smooth member and provider experience.
- Assist in hiring and training of new candidates for the Advocacy team.
- Monitor employee productivity and provide constructive feedback and coaching
- Delegate special projects and cases as necessary
- Work with Senior Manager to develop and support successful completion of goals for the Advocacy team.
- Maintain frequent communication with Senior Manager to ensure efficient operations throughout the Advocacy team.
- Manage escalated inquiries from both internal and external parties.
- Develop and maintaining department policies and procedures.
- Identify enhancements and changes to workflows to increase effectiveness and productivity.
- Deliver specialized service over multiple channels by acting as a single point of contact, maintaining ownership of member resolution and navigating optimal care.
- Manage and coordinate escalated member issue resolution with both internal and external parties, including negotiation of cases.
Required Experience/Education:
- High School Diploma or GED required
- Bachelor's degree in Business or Healthcare Administration preferred or related field
- Minimum of 3 years of healthcare, health insurance, or customer service experience
- Minimum 1 year of supervisory experience
- Experience with negotiations preferred
- Experience in billing, insurance, healthcare, or legal environments preferred
Skills and Abilities:
- Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
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**