Patient Advocate Job Description

Join us in powering the future of healthcare cost containment

Expion Health (formerly HRGi Holdings, Inc.) has an exciting opportunity for a Patient Advocate reporting to the Team Lead, Patient Advocates. Our team of brilliant professionals are continuously expanding the boundaries of the healthcare industry through innovations that intersect data and technology and amplifies human intelligence to result in better outcomes. We need people like you to join in our commitment to drive pure exponential value for our clients and partners.

The Patient Advocate will work as a resource and guide members, enabling them to apply for and receive services related to manufacturer copay assistance. Interact with pharmacies, third party administrators, claims adjustors, medical professionals, and manufacturer copay assistance programs to determine eligible services. The Patient Advocate will handle both inbound and outbound telephone calls and meet expected call metrics. Maintaining files, processing incoming/outgoing email, and provide other general support to members. Responsible for maintaining quality enrollment services and relationships. Requires strong communication skills both written and verbal with the ability to represent and support member and client needs.

Deliver and Execute (70%) - The Patient Advocate role will focus on supporting member and client needs.

Learns and Grows (20%) - Learns through successful and failed experiment when tackling new problems; Actively seeks ways to grow and be challenged using both formal and informal development channels.

Plan and Align (10%) - Builds partnerships and works collaboratively with others to meet shared objectives; Collaborates with other team members across the organization; Relates openly and comfortably with diverse groups of people.

What you bring

To be successful in this role you'll need:

Strong attention to detail
Advanced analytical skills
Ability to adhere to strict deadlines
To feel at home with being part of a collaborative, nimble, and high-performing team within a fast-paced, startup-like environment
Excellent verbal and written communication and listening skills
Strong ethical standards to uphold and foster a culture of confidentiality and integrity
To enjoy pushing your skills and development to manage ambiguity, be adaptable, and cultivate innovation

Responsibilities

Strong medical claims processing or pharmacy billing background and experience.
Working knowledge of medical/pharmacy benefit systems.
Proven ability to complete and manage quick turnaround, tactical projects.
Possess ability to work independently and efficiently under deadlines to meet commitments.
Possess a high degree of creative ability, analytical and technical skills with independent judgment.
Pharmacy Technician or strong pharmacy background.
Medical claims adjustor or strong medical background.
Ability to work as a team member effectively interacting with clients, team members and across departments.
Knowledge of TPA or PBM operations.
Communicates professionally and effectively - both verbal and written.
Provide resources and materials to members and medical professionals.
Maintain member records.
Escalates to leadership any unresolved member enrollment or billing issues.
Resolves problems/issues independently.
Complete enrollments for assigned members.
Work internally with multiple departments to promote timely and accurate resolution of member inquiries.
Maintains strong working relationship with internal and external partners.
Other duties as assigned.

Required Expertise

Experience using Excel for data analysis and reporting.
Extensive knowledge of the Microsoft Office Systems to include, Word, Excel, and Outlook.
Strong organizational skills with the ability to multi-task.
Ability to work in a virtual team environment.
Able to handle responsibility of self-direction with strong organizational and documentation skills.
2+ Years of Customer Service skills preferably in a medical professional setting.

Preferred Skills

Proficiency with contract management software and Microsoft Office Suite.
Ability to work independently and collaboratively in a fast-paced environment.
Excellent time management and organizational skills.
Ability to work independently and as part of a team.
Flexibility and adaptability to change.
Outgoing personality with strong interpersonal and social abilities.
Goal-oriented, self-starting, and able to work without constant supervision.
Resourceful and self-motivated in a remote work environment.
High level of integrity and adherence to ethical standards.
Customer-focused mindset with a commitment to delivering high-quality service.
Demonstrated problem solving and critical thinking skills.

What it's like to work with us

Expion Health has been challenging the industry status quo for over 30 years, leading with ground-breaking innovation in a wide variety of healthcare cost-management solutions. Embracing the latest opportunities that technology can offer within a rapidly evolving industry, we provide exceptional service, technology, and product innovation to meet greater challenges in healthcare cost management.

We have a distributed workforce so you can work from anywhere in the continental United States. Because of our distributed nature we have cultivated a connected culture that includes town halls, one-on-ones with executive leadership, educational forums, and even social clubs.

We offer comprehensive benefits package which includes the following:

100% remote work
100% Employer paid Medical plan option
Dental and vision insurance
Short term disability and long-term disability
Life insurance and AD&D
Supplemental life insurance (Employee/Spouse/Child)
Voluntary Accident Insurance
Voluntary Critical Illness Insurance
Voluntary Hospital Indemnity Insurance
Healthcare and dependent care Flexible Spending Accounts
Healthcare Savings Account
401(k) Savings and Investment Plan with company match
Paid time off
Phone and Internet Allowance