Sharecare, Inc. Research Analyst - Family Health Advocate (Remote) in Atlanta, Georgia
Sharecare is the leading digital health company that helps people -- no matter where they are in their health journey -- unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com.
Job Summary: The role of the Family Health Advocate-Research Analyst is an exciting and integral role in providing meaningful advocacy support to members and their families through personalized resource and referral facilitation, issue resolution and healthcare navigation. In this role you will provide research to support and resolve cases originating from our Family Health Advocates that require additional follow up. Case follow-ups include but are not limited to the coordination of benefits, health claim appeals, re-submissions and/or re-coding, EOB reviews and researching provider availability and scheduling appointments.
Essential Job Functions: * Support follow up needs from Family Health Advocate calls for the following:o Research and resolution to eligibility, claims issues, ID card issues, grievances/appeals, utilization management (UM) status including but not limited to medical, dental, and vision planso Provider search (PCP, specialty, and facility), focused on healthcare cost and quality, and present premier provider options, including but not limited to medical, dental, and vision planso Support for spending accounts, pharmacy, and disability.o Aid with ordering durable medical equipment (DME) o Community resource search* Coordinate issue resolution with providers, payers or 3rd parties for: o Claims adjustments o Grievances and appeals submissions o Utilization management intake or status o Complex pharmacy inquiries o Complex spending account inquiries o Appointment availability* Primary duties include but are not limited to: o Research and documentation of issue resolutions.o Timely management of assigned queue tasks requiring research and resolutiono Work closely with assigned Family Health Advocates to ensure timely resolution and follow up of tasks
Sharecare is an Equal Opportunity Employer and doesn't discriminate on the basis of race, color, sex, national origin, sexual orientation, gender identity, religion, age, disability, genetic information, protected veteran status,or other non-merit factor.