Healthcare Billing Advocate
Building Service 32BJ Benefit Funds
Additional Compensation for Bilingual: $1,000/annually
Health Services
Health Services Manager
Additional Compensation for Bilingual
$Union Code
Management
Building Services 32BJ Benefit Funds(“the Funds”) is the umbrella organization responsible for administering Health, Pension, Retirement Savings, Training, and Legal Services benefits to over 100,000 SEIU 32BJ members. Our mission is to make significant contributions to the lives of our members by providing high quality benefits and services. The Funds oversees and manages $9 billion of dollars in assets, which are made up of many, varied and complex funds. The dollars come from a number of sources, including the property owners who pay into the funds on behalf of their employees, and as such, requires those who oversee and manage the money to be highly skilled financial management people.
For 2025 and beyond, 32BJ Benefit Funds will continue to drive innovation, equity, and technology insights to further help the lives of our hard-working members and their families. We use cutting edge technology such as: M365, Dynamics 365 CRM, Dynamics 365 F&O, Azure, AWS, SQL, Snowflake, QlikView, and more.
Please take a moment to watch our video to learn more about our culture and contributions to our members: youtu.The Health Services Patient Advocate is responsible for the maintenance of relationships with the 5 Star Centers, supporting the operations of the Health Fund Programs, responding to member and provider issues, and assisting members in choosing in-network providers, particularly 5 Star Centers and partnered providers. The Patient Advocate for Health Services addresses member concerns from the initial inquiry stage through resolution, engages in marketing strategies, and offers insights for ongoing quality enhancement of the Health Services Team. Furthermore, this role also contributes to various operational support tasks within the Health Services Team.
Cultivate relationships with management and administrative staff at specified 5 Star Centers to assist in addressing member issues as they arise from the first inquiry to the resolution
Assist members with selecting appropriate providers based on medical criteria and scheduling appointments at 5 Star Centers
Review cases and directly communicate advantages of medical options while also addressing the limitations or alternative options available to members
Investigate member complaints and serve as advocates when a complaint is filed against 5 Star providers to determine a resolution
Utilize Health Services Database to track interactions related to fund programs
Work with members and the providers to verify the correct copay and research claims to identify all billing errors
Handle and address cases involving out-of-network and non-preferred providers and offer members alternatives for in-network and preferred providers
Confirm if the provider is truly in-network or out-of-network, considering situations where providers may have varying statuses at different sites. Reach out to the provider's offices directly to verify their network status, location information, and participation details
Perform other tasks and special projects as required by management
Handle escalated outreach requests
Receive incoming calls through the Health Services queue regarding Health Fund Programs, billing/claim issues and medical services
Direct escalated claim issues to management and Claims Specialist and relay the outcomes to members
Work on simultaneous projects with diverse working groups
Work with minimal supervision and be an effective team player
Work well with physicians and other medical professionals
Read, write and understand English is essential
High School Diploma
Associate’s degree or equivalent work experience in the healthcare industry
Microsoft Office with emphasis on Word and Excel
Strong knowledge base of healthcare industry and medical terminology
Insurance/managed care and claims processing background a plus
Language Skills
Bilingual in English/Spanish is preferred
Shift
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Work near moving or mechanical parts, exposure to radiation, moderate noise.
#J-18808-Ljbffr Building Service 32BJ Benefit Funds
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