Healthcare Benefit Advocate - In Office

Healthcare Benefits Advocate (In Office)

 

 

 

• →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.

 

• 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

• 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

• High School Diploma or equivalent
• Medical terminology knowledge required
• Minimum two years of experience in one or more of the following:
  • Health insurance
  • Benefits administration
  • Health claims processing
  • Medical billing
  • Customer service within a healthcare environment
  • Healthcare reimbursement
  • Third-Party Administration (TPA)
• Strong verbal and written communication skills
• Strong organizational and time-management skills
• Ability to research and resolve benefit and claim issues
• Ability to manage multiple priorities and deadlines
• Strong attention to detail and accuracy
• Ability to maintain confidentiality and professionalism
• Proficiency with Microsoft Office applications, including:
  • Outlook
  • Word
  • Excel
• Reliable attendance during scheduled business hours
• Ability to speak to groups of 20-100 attendees for presentations
• Limited travel required - within the state of Louisiana to conduct benefit enrollment meetings. 

• Associate degree
• Experience interpreting health plan documents and benefit structures
• Experience with medical claims billing, payment, and posting
• Experience handling benefit appeals
• Knowledge of medical coding
• Experience supporting governmental or public entity benefit programs
• Prior benefits customer service experience

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy)  + 10 paid holidays in your first year
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth: Internal training and advancement opportunities
• Culture: A supportive, team-based work environment

 

At CCMSI, strong Benefits Analysts balance service and accuracy. Success in this role is measured by:• Customer service quality – clear, timely, and empathetic responses to member and provider inquiries• Claim accuracy – correct interpretation of plan benefits and claim details• Productivity & responsiveness – effective handling of calls, inquiries, and assigned work• Analytical growth – successful cross‑training and support of analyst‑level tasks• Compliance & documentation – adherence to client contracts and company standards• Professionalism & collaboration – reliability, teamwork, and positive client interaction  

 

This is where we shine, and we hire benefits professionals who want to make an impact with us.

 

At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

 

• Lead with transparency We build trust by being open and listening intently in every interaction.
• Perform with integrity We choose the right path, even when it is hard.
• Chase excellence We set the bar high and measure our success. What gets measured gets done.
• Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come when our clients succeed. 

 

 

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