Care Advocate

• Prioritize tasks and manage a schedule of high-volume introductory video appointments with members
• Promptly answer member questions, assist with product-related needs, and provide personalized recommendations
• Deliver an exceptional member experience and appropriately escalate concerns or questions
• Navigate members’ healthcare networks to ensure access to care and investigate available resources and support
• Coordinate with team members to facilitate timely access to care, provide follow-up, and close the loop with members
• Provide education and resources related to members’ program needs
• Collaborate with cross-functional partners across Care Delivery, Customer Support, Provider, and Product teams
• Execute tasks supporting an optimal member experience and take ownership of outstanding items
• Participate in cross-functional projects and collaborate with other departments
• Identify referral needs and collaborate with Maven providers
• Anticipate and address members’ social determinants of health needs

Care Advocate helping US members navigate Maven’s virtual women’s and family healthcare platform

Care Advocate helping US members navigate Maven’s virtual women’s and family healthcare platform.
Providing education, referrals, and care coordination across Maven’s digital health programs.

• Provide administrative and workflow support across Claims Operations, Subrogation, Litigation Technical Services, and Nurse Case Management
• Serve as a primary contact for internal and external inquiries via phone, email, fax, chat, and web portals
• Manage and process requests for claim-related documentation
• Index, process, and maintain claim files for efficient review and regulatory compliance
• Support claim intake by gathering information, identifying initial compensability considerations, and documenting claims
• Coordinate and process time-sensitive external requests, including workers’ compensation forms, OSHA reports, police reports, conservation records, death certificates, and driver’s license suspensions
• Prepare and distribute claim files to attorneys, subrogation adjusters, and other partners
• Manage ClaimCenter queues and ImageRight for document handling and task completion
• Coordinate IME scheduling, follow-up appointments, transportation, and hotel reservations
• Partner with external vendors including CorVel, OneCall, Metro Reporting, and HomeLink
• Manage certified mailings and collections activities, including monthly expense reconciliation
• Promote MEM Insurance services to policyholders, producers, medical providers, injured workers, and attorneys when appropriate
• Act in accordance with MEM Insurance’s vision, mission, and values

Claims Care Advocate supporting workers’ compensation claims administration at MEM Insurance

Claims Care Advocate

Claims Care Advocate supporting administrative workflows and customer inquiries for MEM Insurance’s workers’ compensation claims operations. Managing claim files, documentation, intake, vendor coordination, and scheduling.

• Provide comprehensive administrative and workflow support across Claims Operations, Subrogation, Litigation Technical Services, and Nurse Case Management.
• Serve as a primary point of contact for internal and external inquiries, delivering timely, accurate, and professional responses via phone, email, fax, chat, and web portals.
• Manage and process requests for claim-related documentation, including wage statements, earnings affidavits, medical records, offer letters, rating requests, and records requests through third-party vendors.
• Index, process, and maintain claim files to ensure all required information is accurately captured for efficient claims review and regulatory compliance.
• Support claim intake activities by gathering necessary information, identifying initial compensability considerations, and documenting claims in accordance with established procedures.
• Coordinate and process time-sensitive external requests, including Division of Workers’ Compensation forms, OSHA reports, police reports, conservation records, death certificates, and driver’s license suspensions.
• Prepare and distribute claim files to attorneys, subrogation adjusters, and other partners as needed.
• Manage activities within ClaimCenter queues and ImageRight to ensure timely document handling and task completion.
• Coordinate logistics for injured workers and claims staff, including IME scheduling, follow-up appointments, transportation arrangements, and hotel reservations.
• Partner with external vendors such as CorVel, OneCall, Metro Reporting, and HomeLink to support claims operations.
• Manage certified mailings and collections-related activities, including monthly expense reconciliation.
• Promote MEM Insurance services to policyholders, producers, medical providers, injured workers, and attorneys when appropriate.
• Act in accordance with MEM Insurance’s vision, mission, and values in all interactions and work activities.

Claims Care Advocate providing support in MEM Insurance’s Claims Department

Claims Care Advocate I

Claims Care Advocate providing administrative and workflow support in MEM Insurance’s Claims Department. Managing inquiries and documentation to ensure smooth claims processes.

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Care Advocate

Claims Care Advocate

Claims Care Advocate I