Healthcare Benefit Advocate
$19 - $24/hr
Mid
Associate's
Metairie, LA, USA
In PersonLimited travel within Louisiana is required for benefit enrollment meetings.
InsuranceClaims Adjudication
No H1B Sponsorship
About the job
Requirements
- A high school diploma or equivalent is required.
- Knowledge of medical terminology is required.
- At least two years of experience in health insurance, benefits administration, health claims processing, medical billing, healthcare customer service, healthcare reimbursement, or Third-Party Administration is required.
- Strong verbal and written communication skills are required.
- Strong organizational and time-management skills are required.
- Ability to research and resolve benefit and claim issues is required.
- Ability to manage multiple priorities and deadlines is required.
- Strong attention to detail and accuracy is required.
- Ability to maintain confidentiality and professionalism is required.
- Proficiency with Microsoft Office applications, including Outlook, Word, and Excel, is required.
- Reliable attendance during scheduled business hours is required.
- Ability to speak to groups of 20–100 attendees for presentations is required.
- Limited travel within Louisiana to conduct benefit enrollment meetings is required.
- Comfort speaking with members, providers, and clients throughout the day is expected.
- Ability to explain complex benefit information is expected.
- Ability to investigate and resolve claim issues is expected.
- Ability to manage multiple priorities in a fast-paced environment is expected.
Responsibilities
- Serve as a primary point of contact for members, healthcare providers, employers, and plan administrators regarding health benefit plans and medical claims.
- Research and resolve claim issues, payment discrepancies, eligibility concerns, and coverage questions.
- Interpret benefit plan documents, schedules of benefits, exclusions, limitations, coordination of benefits, and subrogation provisions.
- Explain claim determinations, payment calculations, deductibles, copays, coinsurance, and out-of-pocket responsibilities.
- Investigate denied claims and assist with claim reconsiderations and appeals.
- Process medical, dental, and prescription benefit transactions in accordance with client plan provisions.
- Collaborate with providers, clients, medical reviewers, and internal teams to obtain information needed for claim resolution.
- Educate members about healthcare benefits and available coverage options.
- Maintain accurate documentation and correspondence within company systems.
- Support claim audits, special projects, and benefit administration activities as assigned.
- Assist with onboarding and training newer team members when requested.
Desired Qualifications
- Experience interpreting health plan documents and benefit structures.
- Experience with medical claims billing, payment, and posting.
- Experience handling benefit appeals.
- Knowledge of medical coding.
- Experience supporting governmental or public entity benefit programs.
- Prior benefits customer service experience.
About the company
CCMSI provides third-party administration services for workers' compensation and property/casualty self-insurance programs. It manages claims and offers risk management and cost-containment strategies for self-insured entities, including group self-insurance associations. The product works by acting as an administrator for a client’s self-insurance program: handling claims, administering payments, and implementing risk controls and cost-saving measures on a fee basis. CCMSI differentiates itself by focusing on the self-insurance niche and serving organizations that bear their own insurance risks, rather than selling traditional insurance policies. The company’s goal is to help clients reduce claim costs and manage their self-insurance programs more effectively.
Company Size
1,001-5,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Danville, Illinois
Founded
1978
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Simplify's Take
What believers are saying
- Florida Insurance Trust moved historical and new claims to CCMSI on January 1, 2026.
- Data Dimensions partnered with CCMSI in October 2025, strengthening claims workflow infrastructure.
- CCMSI’s July 2026 Irvine office move suggests continued operational expansion and client servicing capacity.
What critics are saying
- BBB recorded 29 complaints in three years, including seven closed during 2026.
- California audit complaints against CCMSI reached 7,319 by July 2025, signaling compliance strain.
- Nevada’s March 24, 2026 reversal in Donovan v. City of Henderson keeps CCMSI exposed to claim disputes.
What makes CCMSI unique
- CCMSI calls itself the nation’s largest independent third-party administrator in 2026.
- Its 2026 Florida Insurance Trust transition shows broad workers’ compensation and liability coverage.
- Its iCE claims platform gives clients real-time visibility, supporting faster claims decisions.
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Benefits
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Disability Insurance
- Health Savings Account/Flexible Spending Account
- Unlimited Paid Time Off
- Paid Holidays
- 401(k) Company Match
- Company Equity