Healthcare Advocate (CX)

Responsibilities

• Own cases from AI handoff to resolution, including next steps, outreach strategy, documentation, and follow-through.
• Decide how to route situations (provider, insurer, collections, employer plan, or user education) and define "done".
• Resolve complex user cases end-to-end, from AI handoff through final outcome.
• Contact providers and insurers via phone, email, and fax to verify coverage, correct claim and billing issues, and unblock next steps.
• Investigate and triage issues across benefits, eligibility, claims, prior auth, billing codes, and payment responsibility.
• Advocate for users with persistence, clear escalation paths, and strong documentation.
• Communicate clearly with users, setting expectations, sharing progress, and explaining options in plain language.
• Maintain high-quality case notes.
• Continuously learn healthcare regulations, payer behavior, and internal playbooks.
• Improve operations by collaborating with team, identifying repeat issues, tightening workflows, and building playbooks.
• Partner with Product and Engineering to turn case patterns into product improvements and better automation.

Requirements

Must-haves:

• 2+ years of experience in patient/healthcare advocacy, medical billing, or health insurance.
• Flexible schedule for 40 hours between 7am-8pm EST, 7 days/week (e.g., Sunday–Thursday 9am–6pm or Tuesday–Saturday 10am–7pm).
• Comfortable working directly with provider offices, health insurers, and debt collection groups, including phone-heavy follow-up and escalation.
• Communicate with empathy and clarity, especially for hard news or complex explanations.
• Thrive in ambiguity with bias for action.
• Take documentation seriously with understanding of HIPAA and PHI handling.

Nice-to-haves:

• Early-stage (Series B or earlier) or healthtech startup experience.
• Experience driving patient outcomes related to medical billing (e.g., denials overturned, bills corrected).
• In-depth understanding of US healthcare navigation across coverage, claims, and billing.
• Insurance and billing experience with Medicare, Medicare Advantage, and/or Medicaid.

Compensation

• Annual base salary starts at $50,000 (varies based on experience, expertise, and location).