Claims Care Advocate (Remote)
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AI Summary
Provide comprehensive administrative and workflow support across various claims departments while serving as a primary point of contact for internal and external inquiries. Manage claim-related documentation, process requests, and ensure all files are accurately maintained for regulatory compliance.
Are you someone who takes pride in keeping things organized, supporting others, and delivering excellent service? MEM Insurance is seeking a Claims Care Advocate to provide essential administrative and workflow support within our Claims Department. In this role, you will be a vital partner to Claims Operations, Subrogation and Technical Services, and Nurse Case Management, while also serving as a key point of contact for our policyholders and external partners.
As a Claims Care Advocate, you will help ensure claims processes move smoothly and efficiently by managing records, coordinating requests, supporting adjusters, and responding to customer inquiries with professionalism and care. This role is ideal for someone who enjoys variety in their day, values teamwork, and takes pride in contributing to a high-quality customer experience.
Essential Duties and Responsibilities
- Provide comprehensive administrative and workflow support across Claims Operations, Subrogation, Litigation Technical Services, and Nurse Case Management.
- Serve as a primary point of contact for internal and external inquiries, delivering timely, accurate, and professional responses via phone, email, fax, chat, and web portals.
- Manage and process requests for claim-related documentation, including wage statements, earnings affidavits, medical records, offer letters, rating requests, and records requests through third-party vendors.
- Index, process, and maintain claim files to ensure all required information is accurately captured for efficient claims review and regulatory compliance.
- Support claim intake activities by gathering necessary information, identifying initial compensability considerations, and documenting claims in accordance with established procedures.
- Coordinate and process time-sensitive external requests, including Division of Workers’ Compensation forms, OSHA reports, police reports, conservation records, death certificates, and driver’s license suspensions.
- Prepare and distribute claim files to attorneys, subrogation adjusters, and other partners as needed.
- Manage activities within ClaimCenter queues and ImageRight to ensure timely document handling and task completion.
- Coordinate logistics for injured workers and claims staff, including IME scheduling, follow-up appointments, transportation arrangements, and hotel reservations.
- Partner with external vendors such as CorVel, OneCall, Metro Reporting, and HomeLink to support claims operations.
- Manage certified mailings and collections-related activities, including monthly expense reconciliation.
- Promote MEM Insurance services to policyholders, producers, medical providers, injured workers, and attorneys when appropriate.
- Act in accordance with MEM Insurance’s vision, mission, and values in all interactions and work activities.
Qualifications
Education
- High school diploma or equivalent required
- Bachelor’s degree preferred
Licenses
- Valid driver’s license required
Experience
- One or more years of experience in a professional office environment
- Prior exposure to Workers’ Compensation or a similar industry is preferred
Company Culture and Values
At MEM Insurance, we are committed to our vision, mission, and values. We foster a culture of collaboration, integrity, and innovation. Our team is passionate about delivering exceptional service to our customers while supporting each other’s growth and success. We believe in accountability, continuous learning, and creating an environment where employees feel valued and empowered.
Diversity Statement
MEM Insurance is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that varied perspectives drive innovation and strengthen our ability to serve our customers and communities.
Total Rewards Overview
- Health Plans: Medical, Dental, and Vision
Includes fertility benefits, fully paid preventative care, and adult orthodontia. - Annual Performance Based Bonus
- Employer-Paid Life and Disability Benefits:
Life Insurance (3x base salary), AD&D, Short and Long-term Disability. - Wellness and Recognition Program: Employer-paid incentives for employees and spouses.
- Flexible Spending Account and Dependent Care options
- Health Savings Account: Generous employer contribution.
- Time Away from Work:
Generous PTO, 11 Holidays + 4 Early Releases, 16 Hours Volunteer Time Off, 20 Days Paid Parental Leave, Marriage, Bereavement, and Jury Duty leave. - Employee Assistance Programs
- 401k Retirement Plan: Employer match and profit sharing.
- Adoption Assistance and Tuition Assistance
Notice Regarding Use of Artificial Intelligence
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.
MEM may use artificial intelligence (AI) tools to more efficiently facilitate and assist in decisions involving recruitment, hiring, promotion, renewal of employment, selection for training or apprenticeship, discharge, discipline, tenure, or the terms, privileges, or conditions of employment. Any such use of AI tools will comply with all applicable laws.
Job Details
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