Family Health Advocate
CurrentAs the first point of contact for telephonic and virtual inquiries, I assume a pivotal role in guiding individuals through the intricacies of their healthcare journey. My responsibilities include addressing copays/coinsurance, premiums, deductibles, claims/post-claims reviews, appeals, along with numerous other health plan related inquiries. I underscore a commitment to high-quality interactions with steadfast adherence to HIPAA standards. I meticulously document all interactions, reviewing for accuracy to safeguard Protected Health Information (PHI). An integral aspect of my role involves streamlining healthcare access, managing tasks such as coordinating care with Primary Care Providers (PCPs), specialists, or the Clinical Team, scheduling appointments, securing referrals or authorizations, and providing cost estimates. Additionally, I deliver comprehensive member education on employee-sponsored third-party programs, employee benefits, and incentives, employing tailored strategies to optimize the utilization of diverse employee offerings. My overarching objective is to focus on achieving health goals, reducing costs, and enhancing the overall quality of life.