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Member Advocate – Negotiator
Christian Care MinistryMember Advocate Negotiator resolving balance bills for members at Christian Care Ministry. Engaging with providers and negotiating payments based on healthcare guidelines and member advocacy.
Posted 6/29/2026full-timeMelbourne • Florida • 🇺🇸 United StatesMid-LevelSenior💰 $66,500 - $90,500 per yearWebsite
About the role
Key responsibilities & impact- Collaboration with the Member Advocate
- Receive balance-bill cases from the Member Advocate following intake, eligibility verification, and pathway determination; review the case file for completeness before initiating negotiation
- Coordinate with the assigned Member Advocate on member context, prior provider communications, and any sensitivities that should shape negotiation tone or approach
- Provide settlement updates and projected closure timeline to the Member Advocate on a defined cadence so the Advocate can keep the member informed within SLA windows
- Hand back to the Member Advocate at settlement for member confirmation, CSAT capture, and case closure in the case management system
- Research Medicare, market benchmarks, and applicable fee schedules to develop negotiation strategy and opening offers for each case
- Review provider claims for CPT/ICD coding accuracy, and billing reasonableness prior to negotiation; flag suspected coding errors or upcoding for Paralegal review when warranted
- Prepare a documented negotiation plan for each case identifying opening offer, target range, walk-away threshold, and supporting evidence
- Conduct direct payment negotiations with the provider or facility that issued the balance bill to the member, on the member’s behalf
- Manage the full negotiation lifecycle: provider outreach, counter-offer cycles, settlement execution, and case closure
- Operate within Negotiator-defined settlement authority thresholds; obtain Advocacy Team Manager authorization for settlement parameters that exceed those thresholds
- Where the case has been routed through delegation, partner with the delegated team or assume internal handling per the established hand-off criteria; ensure no duplicative provider outreach
- Document all negotiation activity, communications, and settlement terms in the case management system in real time and to audit-ready standards
- Maintain accurate, current case status so that the Member Advocate, Manager, and any delegated vendor can rely on a single source of truth for the case
- Collaborate with paralegals on legal case file preparation for complex, high-dollar, or multi-party negotiations
- Escalate unresolvable cases to the Advocacy Team Manager and coordinate transition to alternative dispute resolution, third-party arbitration, or external legal counsel as authorized
- Coordinate with Claims, Network Management, or Provider Relations when a negotiation reveals a contracting, configuration, or claim-processing issue requiring upstream correction
- Identify recurring provider billing patterns and report systemic issues to the Advocacy Team Manager for network-level correction
- Maintain current knowledge of applicable state balance billing law and the organization’s sharing program guidelines as they affect provider negotiation strategy
- Contribute lessons learned and successful negotiation tactics back to the team’s playbook and training materials
- Contribute to the exercise and expression of Christian Care Ministry’s Christian beliefs
- All other duties as assigned
Requirements
What you’ll need- Bachelor’s degree in healthcare administration, Business, or Finance, required; combination of education or equivalent experience may satisfy this requirement
- 3+ years of experience in healthcare payment negotiation, provider contracting, or provider relations, required
- Demonstrated experience negotiating directly with hospitals, facilities, or physicians’ groups required
- Experiencing operating within or alongside a delegated payment-integrity / provider dispute vendor relationship a strong plus
- Familiarity with healthcare sharing models and shared-eligibility determinations a plus
- Prior experience handling third-part arbitration filings and working with managed care contracts preferred
Benefits
Comp & perks- 100% paid Medical for employees/99% for family
- Generous employer Health Savings Account (HSA) contributions
- Employer-paid Life Insurance (3x salary) and Long-term Disability Insurance
- 6 weeks of paid parental leave (for both mom and dad)
- Dental - two plans to choose from
- Vision
- Short-term Disability
- Accident, Critical Illness, Hospital Indemnity
- 401(k) – up to 4% match on ROTH or Traditional contributions
- Generous paid-time off and 11 paid holidays
- Wellness plan including Financial, Occupational, Mental/Spiritual, and Physical health incentives up to $50/mo
- Employee Assistance Program including no cost, in-person mental health visits and employee discounts
- Monetary Anniversary Awards Program
- Monetary Birthday Awards
- Tuition Reimbursement Program
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Negotiation Strategy DevelopmentProvider OutreachSettlement ExecutionClaims ReviewBalance Billing Law Knowledge
Soft Skills
CollaborationCommunicationProblem-SolvingAttention to DetailAdaptability