What are the responsibilities and job description for the Advocacy Specialist position at GBS Benefits, Inc.?
Overview:
GBS Benefits, Inc. is the leader in experience, innovation, and services when it comes to customizing the employee benefits offerings for our clients. GBS Benefits has created a culture of respect, trust, hard work, and fun. When you love your job and the people around you, remarkable things can happen. We carry great excitement in our work, knowing that we have a tremendous positive impact on the larger scale. We partner with over 1,000 companies in building and protecting their dreams and visions. We invite you to investigate this job opportunity at GBS. This job description will not be all inclusive but is intended to give you a road map and an overview. Come make a difference with us!
Description:
Our GBS Advocacy Specialist assists clients in navigating the intricacies of the healthcare industry, including understanding their benefits and available resources. The primary objective of an Advocacy Specialist is to empower clients by providing support, education, and resources. When clients face challenges, we guide them in making informed healthcare decisions and understanding the subsequent steps.
As an Advocacy Specialist, you’ll assist clients in various ways:
- Facilitating the acquisition of their benefit cards.
- Helping them access their carrier portals.
- Analyzing and researching denied medical claims.
- Taking the lead in resolving claims issues on behalf of our members.
Additionally, you’ll escalate complex matters to managerial levels within insurance carriers or group administrators through key contacts. Your role involves handling intricate issues with minimal supervision.
Essential Duties and Responsibilities:
- Confidence Building and Communication:
- Instill confidence in our services to encourage members to call back.
- Clearly communicate your plan, outcomes, and timeframes, aiming to exceed expectations.
- Emotional Support and Value-Added Assistance:
- Recognize and ease member anxiety or frustration.
- Go beyond initial inquiries by providing relevant information and assistance.
- Advocacy and Network Building:
- Advocate for client coverage in medical procedures and treatments.
- Establish and maintain key contacts within insurance carriers and relevant resources.
Essential Duties and Responsibilities (continued):
- Claims Resolution and Education:
- Investigate denied claims and verify coding.
- Educate members on insurance plan provisions.
- Exceptional Service:
- Provide follow-up that exemplifies the GBS difference.
Skills and Knowledge:
- Sound reasoning and judgment to decipher a multitude of incoming issues.
- Maintain composure, analyze situations objectively, and provide helpful assistance.
- Strong verbal & written communication.
- Ability to decipher resources for yourself and client and know when to utilize other GBS departments.
- Must be able to effectively prioritize tickets and meet deadlines.
- Insurance / Claims / EOB knowledge highly recommended.
- Technically savvy and proficient with ongoing improvements in processes.
- Proven use and understanding of Microsoft Office.
Performance Expectations:
- Ability to consistently attend work, meetings and required training or staff events.
- Must work with respect and work well with diverse personalities.
- Must meet or exceed team and overall company expectations.
- Must work well independently as well as contribute to a team environment.
Working Conditions / Essential Functions:
- This position enjoys the benefits and climate control of a quiet office environment. Employees are provided with ergonomically sound workspaces. Work is accomplished at a computer terminal either sitting or standing. Employees must access, input, and retrieve information from the computer system.Comfort and efficiency are considered in employee workspaces. Daily work includes computer interfacing, data entry, communications (electronic and physical), movement throughout the office, attending meetings, etc.
- Physical demands include the ability to lift and move objects (typically 0 – 10 lbs.) and visually monitor information/data on a computer screen.
- The working environment described above provides a detailed representation of what employees might encounter in the workplace while performing the essential duties of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties of the job.
This job description is not designed to cover or to contain a comprehensive listing of activities,
duties, or responsibilities that are required of the employee.
