Customer Advocate Level I

Position Summary

As a Customer Advocate, you will be supporting communication between MedRisk/SPNet's network providers and referring adjusters and nurse case managers. You will report to the Customer Advocate Team Lead and/or Supervisor to help strengthen MedRisk/SPNet's referral process, ensuring efficient workflow, while increasing customer satisfaction. Acting as liaison, the Customer Advocate tracks patient progress from the start of treatment, throughout treatment, and through to closure by obtaining relevant case updates from providers, including but not limited to dates of service, compliance, treatment notes, and continued authorization. They are responsible for maintaining the integrity of the case file and related documents and communicating professionally and effectively with the customer.

Primary Duties and Responsibilities

Level I:

• Manage claims and monitor case status by confirming patient attendance with network providers, and addressing any concerns regarding compliance


• Properly update all case related data to MedRisk's database/platform


• Track and relay authorization to our providers as directed by the clients with confirmations to the adjuster and NCM


• Be knowledgeable regarding the client's unique needs and respond appropriately


• Build approachable, professional relationships with providers and referring customers.


• Compliance with HIPAA and URAC guidelines


• Employee is expected to work a minimum of 60 tasks daily

Qualifications

• Bachelor's Degree preferred; impeccable customer service skills with 2-3 years of experience preferred


• Healthcare experience required; minimum of 1 year preferred


• Experience working with a US company (PH specific)


• Ability to work independently and multi task in a fast paced environment


• Detail oriented


• Excellent verbal & written communication skills


• Basic knowledge of Microsoft Word, Excel, Outlook and Zoom


• Computer skills in Windows environment


• Time management and strong organizational skills


• Adaptability


• Ability to receive constructive feedback


• Strong work ethic