Benefit Support Advocate

The Benefit Services Advocate serves as the central coordination point for scheduling medical appointments and procedures for members enrolled in Institutional Special Needs Plans (ISNP) and Institutional-Equivalent Special Needs Plans (IESNP). This position works closely with long-term care facility staff, internal Benefit Services team members, and provider offices to ensure that appointments are scheduled promptly and communicated accurately. The Advocate plays a critical role in facilitating access to care by ensuring the appropriate authorization process is initiated and completed when necessary., * Act as the primary contact for long-term care facilities requesting medical appointments or procedures for ISNP/IESNP members.

• Schedule appointments with physicians, specialists, diagnostic services, or other providers on behalf of members.
• Ensure appointments are coordinated based on provider availability, member needs, and facility resources.
• Initiate internal communication with the Benefit Services team to determine if an authorization is required for the scheduled services.
• Track and follow up on the status of authorizations and ensure timely completion prior to scheduled appointments.
• Relay appointment and authorization details back to the requesting facility or caregiver contact clearly and efficiently.
• Maintain accurate documentation in the appropriate systems for appointment requests, scheduling status, and authorization needs.
• Escalate urgent scheduling issues or barriers to care to leadership as needed to avoid delays in treatment.
• Build and maintain positive working relationships with facility staff and provider offices to support smooth coordination of care.

Do you have experience in Stakeholder relationship building?, Do you have a High school diploma or GED?, * High school diploma or equivalent required.

• Minimum of 2 years of experience in healthcare coordination, medical office scheduling, or insurance authorization processes, preferably within a managed care or long-term care setting.
• Familiarity with Medicare Advantage plans, especially ISNP or IESNP populations, is highly desirable.
• Strong interpersonal and communication skills, with the ability to manage multiple stakeholders effectively.
• Detail-oriented with excellent organizational and time-management abilities.
• Proficient in using Microsoft Office products and experience with healthcare software systems or electronic health records (EHRs) is preferred.