Healthcare Case Specialist

Marshall County, WV - USA

Monthly Salary: $ 55000 - 60000

Experience Required: 1-3years

Posted on: 5 hours ago

Vacancies: 1 Vacancy

Job Summary

This is a remote position.

At this time we are unable to consider candidates residing in CA NY MA NJ or WA. Applicants from all other U.S. states are encouraged to apply.

REQUIRED: As part of the application process all candidates must complete a Culture Index profile. Applications will not be considered until the profile is completed. Please complete the assessment at:

Position Summary

We are seeking a dependable detail-oriented Healthcare Case Specialist (also known as Member Advocate in CareGuide) to provide thorough accurate and compassionate support to members navigating complex healthcare and medical billing systems. This role is ideal for someone who values precision consistency and quality service while building trust through clear reliable communication.

Member Advocates are the heart and voice of the organization providing compassionate strategic and results-oriented support to members navigating complex healthcare systems. They serve as key liaisons between members healthcare providers internal teams and external partners. From medical bill negotiation to facility coordination and case documentation this role is integral to both member experience and organizational impact. Member Advocates ensure every member feels seen heard and supported while driving measurable savings and satisfaction outcomes. This role requires strong communication and organizational skills the ability to handle sensitive medical information with discretion and a commitment to maintaining compliance with HIPAA regulations.

Candidates with experience as a Healthcare Case Manager Claims Coordinator Litigation Support Specialist Medical Secretary Medical Administrative Assistant Medical Records Specialist Patient Service Representative Medical Transcriptionist or Medical Biller are strongly encouraged to apply. Bilingual candidates are highly desirable and will thrive in this diverse and dynamic environment.

REQUIRED: As part of the application process all candidates must complete a Culture Index profile. Applications will not be considered until the profile is completed. Please complete the assessment at: YOU Will Do

This posting provides a general overview of the role and does not include all daily responsibilities or essential job functions.

Serve as the trusted advocate by delivering professional empathetic customer service and maintaining clear reliable communication with members and healthcare providers.
Manage a caseload with accuracy and timeliness coordinating appointments provider research financial assistance applications and settlements.
Investigate and resolve medical billing concerns negotiate cost reductions with providers and identify prescription or financial aid programs to ease members financial burdens.
Draft and prepare settlement offers appeal letters and other documentation while ensuring compliance with HIPAA legal requirements and partner standards.
Enter and maintain accurate records in case management systems track deadlines monitor progress and ensure cases are resolved effectively.
Address member complaints fairly identify administrative or process gaps and provide feedback to strengthen internal tools workflows and service delivery.
Collaborate with internal teams on case handling structured reporting and special projects to support organizational goals.

Requirements

High school diploma or equivalent required; Associate or Bachelors degree in a health-related business or social service field is a plus
2 years of experience in healthcare navigation billing advocacy case management or a customer-facing role
Experience working with vulnerable populations or navigating complex systems is strongly preferred
Experience handling high-pressure situations with empathy patience and professionalism
Prior experience in medical billing or insurance negotiations is a plus
Familiarity with HIPAA and healthcare confidentiality standards

Bonus Points for Experience In:

Bilingual abilities are a plus
Experience in sensitive negotiations with healthcare providers and billing offices to achieve positive outcomes for members
Experience in managing high caseloads and utilizing case management systems.

Benefits

Make a Difference: Help businesses and employees lower healthcare costs while improving their access to care.

Structured & Supportive Environment: We provide clear processes strong leadership and a team-oriented culture where you can thrive.

Growth Potential: We invest in our people. This role has clear pathways for career advancement.

Work-Life Balance: At this time we are unable to consider candidates residing in CA NY MA NJ or WA. Applicants from all other U.S. states are encouraged to apply.

The base salary range for this position is budgeted at $55000-$60000.

We also offer a competitive benefits package that includes medical dental and vision insurance wellness resources 401(k) matching unlimited paid time off and more.

REQUIRED: As part of the application process all candidates must complete a Culture Index profile. Applications will not be considered until the profile is completed. Please complete the assessment at:

Required Skills:

Serve as the members advocate by delivering professional empathetic customer service and maintaining clear reliable communication with members and healthcare providers. Manage a caseload with accuracy and timeliness coordinating appointments provider research financial assistance applications and settlements. Investigate and resolve medical billing concerns negotiate cost reductions with providers and identify prescription or financial aid programs to ease members financial burdens. Draft and prepare settlement offers appeal letters and other documentation while ensuring compliance with HIPAA legal requirements and partner standards. Enter and maintain accurate records in case management systems track deadlines monitor progress and ensure cases are resolved effectively. Address member complaints fairly identify administrative or process gaps and provide feedback to strengthen internal tools workflows and service delivery. Collaborate with internal teams on case handling structured reporting and special projects to support organizational goals.

Required Education:

High school diploma or equivalent required; Associate or Bachelors degree in a health-related business or social service field is a plus2 years of experience in healthcare navigation billing advocacy case management or a customer-facing roleExperience working with vulnerable populations or navigating complex systems is strongly preferredExperience handling high-pressure situations with empathy patience and professionalismPrior experience in medical billing or insurance ne

This is a remote position.At this time we are unable to consider candidates residing in CA NY MA NJ or WA. Applicants from all other U.S. states are encouraged to apply. REQUIRED: As part of the application process all candidates must complete a Culture Index profile. Applications will not be co...