Healthcare Advocate - In Office

Overview

Healthcare Benefits Advocate (In Office)

Location: Metairie, LA (Onsite)
Schedule: Monday – Friday, 8:00 AM – 4:30 PM (37.5 Hours per Week)
Compensation: $19.00 – $24.00 per hour

Please Note: This is a fully onsite position located in our Metairie, Louisiana office. Remote and hybrid work arrangements are not available for this role.

At CCMSI, we are committed to providing exceptional service and support to our clients, members, and partners. As a certified Great Place to Work® and employee-owned organization, we believe our success starts with dedicated employees who are passionate about helping others.

We foster a collaborative culture where employees are empowered to grow professionally, contribute meaningful ideas, and make a positive impact every day.

CCMSI is seeking a Healthcare Benefits Advocate to serve as a trusted resource for members, healthcare providers, employers, and plan administrators regarding health insurance benefits, medical claims, eligibility, and coverage questions.

This is not a call center role. We are seeking someone with a strong understanding of health insurance, medical claims, benefits administration, medical billing, or healthcare reimbursement who can confidently interpret benefit plans, investigate claim issues, explain coverage provisions, and advocate for appropriate claim resolution.

The ideal candidate enjoys helping people, is comfortable speaking with members and providers throughout the day, and can successfully navigate complex healthcare benefit questions while delivering exceptional service.

What You’ll Do

• Serve as a primary point of contact for members, healthcare providers, employers, and plan administrators regarding health benefit plans and medical claims.

• Research and resolve claim issues, payment discrepancies, eligibility concerns, and coverage questions.

• Interpret benefit plan documents, schedules of benefits, exclusions, limitations, coordination of benefits, and subrogation provisions.

• Explain claim determinations, payment calculations, deductibles, copays, coinsurance, and out-of-pocket responsibilities.

• Investigate denied claims and assist with claim reconsiderations and appeals.

• Process medical, dental, and prescription benefit transactions in accordance with client plan provisions.

• Collaborate with providers, clients, medical reviewers, and internal teams to obtain information necessary for claim resolution.

• Educate members regarding healthcare benefits and available coverage options.

• Maintain accurate documentation and correspondence within company systems.

• Support claim audits, special projects, and benefit administration activities as assigned.

• Assist with onboarding and training of newer team members when requested.

We’re looking for someone who understands the healthcare and insurance industry and enjoys helping others navigate benefit-related questions.

Ideal backgrounds include:

• Health insurance

• Third-Party Administration (TPA)

• Employee benefits administration

• Medical claims processing

• Medical billing and reimbursement

• Provider relations

• Healthcare customer advocacy

• Eligibility and enrollment administration

Successful candidates are:

• Comfortable speaking with members, providers, and clients throughout the day

• Confident explaining complex benefit information

• Naturally curious and investigative when resolving claim issues

• Highly organized and detail oriented

• Professional, empathetic, and service focused

• Able to manage multiple priorities in a fast-paced environment

• Self-motivated and dependable

Required Qualifications

• High School Diploma or equivalent

• Medical terminology knowledge required

• Minimum two years of experience in one or more of the following:
  • H…