Wellthy is a digital care concierge for families with chronic, complex, and ongoing care needs. By tackling the logistical aspects of caregiving, Wellthy helps employers increase productivity, improve retention, and reduce time away—all while giving employees the support they need to care for themselves and those they love.
As our Virtual Care Adviser, you will assist with various tasks to support families and individuals and address their unique caretaking needs.
We love collaborating here at Wellthy and in this role you will work closely with Care Coordinators and other Care Advisers.
You will report directly to the Team Lead and Care Manager.
To be successful in this role:
Maintain a task load conducive to employment status (FT/PT)
Conduct research and assess large amounts of information effectively and creatively.
Remains solution focused and engages in creative thinking to secure quality solutions in a timely way
Collaborate with Care Coordinators, and Managers by using your expertise and know-how to support tasks to help Wellthy members
Collaborate with Care Coordinators, Care Advisers/Specialists,, and Managers to help Wellthy Care Recipients and families, by using your expertise and know-how to support with tasks
Support with improving and updating Wellthy’s Guides and knowledge Resources.
Represent Wellthy at events such as health fairs, open enrollments, and internal/external webinars (travel and expenses covered by Wellthy; if interested and when applicable)
Other non-client-specific work, including but not limited to: feedback and guidance on Wellthy’s product, service, guides, etc.; contribution to the team culture; writing and advising for marketing materials; and support and teamwork for other service team members.
Responsible for preparing and submitting claims to insurance companies
Understand the complexities of insurance policies, coding procedures, and other regulations
Use medical coding systems to translate medical procedures, diagnoses, and treatments into standardized codes for accurate billing
Consistent communication and follow up with insurance companies, facilities, and providers to resolve billing-related issues
Contact providers to request submission of prior authorizations for services and procedures
Responsible for researching and providing explanations of charges for medical services
Provide information about insurance policy benefits, coverage, and eligibility
Verify insurance coverage for specific services and procedures
Investigate claim denials and request submission of corrected claims from medical providers, or appeal the claim determination if necessary
Assist in obtaining gap exceptions for medically necessary out-of-network services
Follow up with insurance companies on pending or overdue claims to ensure timely processing and payment
Collaborate with providers to obtain necessary documentation for claim submission and resolve billing-related issues
Track payments for multiple insurance claims
The Role
In the Care Adviser (Financial) role, you will report to a Care Manager and work directly with Wellthy Care Coordinators, as well as fellow Care Advisers, to assist with various tasks to support families and individuals and address their unique caretaking needs. Tasks you may work on can depend on your area of expertise, but may include: researching and vetting legal services, financial and government assistance programs, providing your expertise when it comes to insurance coverage and plan types (such as Medicare, Medicaid, Medi-Cal, Long-Term Care Insurance), as well as billing, claims, and health insurance appeals.
You will drive some of the following efforts:
You will collaborate with Care Coordinators, Care Advisers/Specialists, Team Leads, and Managers to help Wellthy Care Recipients, by using your expertise and know-how to complete our Financial team-related tasks.
Support with improving and updating Wellthy’s Guides and Team Resources.
Represent Wellthy at events such as health fairs, open enrollments, and internal/external webinars (travel and expenses covered by Wellthy)
Other non-client-specific work, including but not limited to: feedback and guidance on Wellthy’s product, service, guides, etc.; contribution to the team culture; writing and advising for marketing materials; and support and teamwork for other service team members.
Qualifications required for this role include:
It is important to note that you will need the ability to work in a fast-paced environment, be flexible, creative, and be comfortable in knowing that we are constantly evolving.
Remote Work Experience
Associates Degree or Higher
5+ years work experience in Medical Billing and/or Coding
Your experience may include:
1+ years in customer service or administrative experience
2+ years experience and familiarity of commercial, private or Government insurance plans such as Medicare and Medicaid
Certification in Medical Coding, Long-term Care Insurance, or Patient Advocacy
Knowledge in Health Insurance Appeals
Knowledge of legal terms and understanding of legal documents
Ability to work independently while being communicative and collaborative with Coordination Team
Remote work experience preferred
Proficiency in more than one language is a plus
Proficiency with macOS systems, GSuite, Slack, and 1Password preferred, but not required
Strong ethical standards and a respect for client confidentiality
Ability to integrate and collaborate well with others while adapting to evolving service experiences
Knowledge of and ability to navigate the healthcare sector
Salary:
The starting rate is $22.00-$26.00/hour.
Total Rewards Package
Remote work environment
Medical, dental and vision benefits
Retirement saving account with matching company contributions
Mental health benefits
15 days paid vacation, two additional days for each subsequent years (up to a maximum of 25 days)
Professional development initiatives for growth
Generous parental leave (maternal and paternal) during a new child’s first year (born into family or adopted)
Location:
This is a fully remote position. Our Wellthian’s are located throughout the United States but we are currently not accepting candidates in the following states: Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island and West Virginia.
Role requirements:
To work from home, you must have a strong internet connection, quiet space to take calls and a professional (distraction free) environment.
What to expect in the hiring process?
Before hiring a Care Adviser, we put individuals through a rigorous screening process which includes interviews, case study, reference checks, and background checks.
Training
If a Care Adviser is invited to join the team, they then go through a two-week bootcamp training program with a daily curriculum of learning, shadowing, and hands-on work that is both self-guided and collaborative with other Advisers, Coordinators, and their Team Lead over Zoom Video. At the end of the two weeks, a Care Adviser must pass our certification test before being allowed to work with families. The certification tests for proficiency in:
Technical knowledge
Use of Wellthy platform
Customer service
The Wellthy way of communicating and delivering a high-touch customer experience
What’s next?
We encourage you to apply for this position by clicking the apply here button on job posting and attaching your resume. We understand that there is no “perfect” candidate and never expect every candidate to meet 100% of the qualifications listed above. We look for our Wellthian’s to enhance and advance our company from their past experiences. Our diverse backgrounds and perspectives are what make Wellthy a top company to work for. We hope that it not only encourages you but excites you to get started with our process.
All applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability protected veteran status, or any other characteristics protect by law.