Remote Healthcare Service Advocate

Title: Remote Healthcare Service Advocate | Provider Services

Job Summary

The Customer Service Advocate is responsible for providing exceptional support to healthcare providers by handling emails, faxes, and web inquiries related to healthcare claims, appeals, and payment concerns. This role serves as the primary point of contact for providers, ensuring timely resolution of inquiries while delivering a high level of customer service and maintaining compliance with company policies and service standards.        

Position Summary

Customer Support

• Handle healthcare providers regarding claims, payments, appeals, and other account-related inquiries.
• Respond to provider inquiries received via E-Mail, Fax, and web requests in a timely and professional manner.
• Provide accurate claim status updates and explain claim outcomes based on company guidelines.
• Resolve provider concerns by researching claim information and coordinating with internal departments when necessary.
• Deliver exceptional customer service while meeting established quality and productivity standards.

Claims Inquiry Support

• Review claims requiring additional research, reprocessing, or finalization.
• Process faxed claims and review Explanation of Benefits (EOBs).
• Verify claim information and ensure requests are handled accurately.
• Escalate complex issues following established procedures.

Appeals & Payment Support

• Provide status updates on provider appeals.
• Follow up on aging appeals and request additional information when necessary.
• Process requests for upheld and late submission letters.
• Research payment inquiries and assist with stop payment requests.
• Coordinate requests for check reissuance and copies of cashed check images.
• Review and monitor payment tracers.

Administrative Support

• Monitor incoming emails and web requests throughout the day.
• Document all customer interactions accurately in the system.
• Maintain confidentiality and comply with HIPAA and company policies.
• Meet service level agreements (SLAs), quality, and productivity metrics.

Qualifications

• High school diploma or equivalent; college degree is an advantage.
• At least 4 years of experience in healthcare contact center, provider services, or claims support environment.
  
• Basic knowledge of healthcare claims, EOBs, appeals, and payment processes is an advantage.
  
• Excellent analytical, multitasking, organizational, and communication skills with strong attention to detail and accuracy.
• Tech-savvy, with proficiency in MS Office and online systems.
• Ability to work flexible shifts, including nights, weekends, and holidays.
• Must be located in or near Manila (preferred).
  
• Can start ASAP. This is an urgent hiring.
  

**Work Arrangement: This position is currently offered on a REMOTE work basis. However, please note that this is a performance-based role, and the company reserves the right to require employees to report onsite at any time based on business needs, performance evaluations, operational requirements. Flexibility to transition to an office-based setup when necessary is expected.

***WORK FROM HOME REQUIREMENTS***

• Requires a stable primary internet connection of at least 50Mbps,
• Reliable backup connection to ensure continuity of remote work.
• Required to provide a speed test during interview (initial)
• Ability to directly hardwire to your modem
• Required to have a quiet dedicated work area.

Why You’ll Love Working with Us:

• 🏠 Work Remotely
• 💰 Competitive Pay + 13th Month Salary
  
• 🩺Comprehensive HMO Coverage (Medical & Dental)
• 💻 Equipment Provided – Everything you need to succeed
• 🚀 Career Growth – Be part of a dynamic and supportive team that values your expertise
• ⚡ Immediate Hiring – Start ASAP and make an impact from day one

COMPANY OVERVIEW:

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers. 

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers.  The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.  The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.