Healthcare Benefit Advocate - In Office

Overview

Location: Metairie, LA (Onsite)Schedule: Monday – Friday, 8:00 AM – 4:30 PM (37.5 Hours per Week)Compensation: $19.00 – $24.00 per hour

Please Note: This is a fully onsite position located in our Metairie, Louisiana office. Remote and hybrid work arrangements are not available for this role.

Build Your Career With Purpose at CCMSI

At CCMSI, we are committed to providing exceptional service and support to our clients, members, and partners. As a certified Great Place to Work® and employee-owned organization, we believe our success starts with dedicated employees who are passionate about helping others.

We foster a collaborative culture where employees are empowered to grow professionally, contribute meaningful ideas, and make a positive impact every day.

Job Summary

CCMSI is seeking a Healthcare Benefits Advocate to serve as a trusted resource for members, healthcare providers, employers, and plan administrators regarding health insurance benefits, medical claims, eligibility, and coverage questions.

This is not a call center role. We are seeking someone with a strong understanding of health insurance, medical claims, benefits administration, medical billing, or healthcare reimbursement who can confidently interpret benefit plans, investigate claim issues, explain coverage provisions, and advocate for appropriate claim resolution.

The ideal candidate enjoys helping people, is comfortable speaking with members and providers throughout the day, and can successfully navigate complex healthcare benefit questions while delivering exceptional service.

Responsibilities

What You'll Do

• 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 necessary for claim resolution.

• Educate members regarding 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 of newer team members when requested.

Who We're Looking For

We're looking for someone who understands the healthcare and insurance industry and enjoys helping others navigate benefit-related questions.

Ideal backgrounds include:

• Health insurance
• Third-Party Administration (TPA)
• Employee benefits administration
• Medical claims processing
• Medical billing and reimbursement
• Provider relations
• Healthcare customer advocacy
• Eligibility and enrollment administration

Successful candidates are:

• Comfortable speaking with members, providers, and clients throughout the day
• Confident explaining complex benefit information
• Naturally curious and investigative when resolving claim issues
• Highly organized and detail oriented
• Professional, empathetic, and service focused
• Able to manage multiple priorities in a fast-paced environment
• Self-motivated and dependable

Qualifications

Required Qualifications

• High School Diploma or equivalent
• Medical terminology knowledge required
• Minimum two years of experience in one or more of the following:
  • Health insurance
  • Benefits administration
  • Health claims processing
  • Medical billing
  • Customer service within a healthcare environment
  • Healthcare reimbursement
  • Third-Party Administration (TPA)
• Strong verbal and written communication skills
• Strong organizational and time-management skills
• Ability to research and resolve benefit and claim issues
• Ability to manage multiple priorities and deadlines
• Strong attention to detail and accuracy
• Ability to maintain confidentiality and professionalism
• Proficiency with Microsoft Office applications, including:
  • Outlook
  • Word
  • Excel
• Reliable attendance during scheduled business hours
• Ability to speak to groups of 20-100 attendees for presentations
• Limited travel required - within the state of Louisiana to conduct benefit enrollment meetings. 

Preferred Qualifications

• Associate degree
• 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

Why You’ll Love Working Here

• 4 weeks (Paid time off that accrues throughout the year in accordance with company policy)  + 10 paid holidays in your first year
• Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance
• Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP)
• Career growth: Internal training and advancement opportunities
• Culture: A supportive, team-based work environment

How We Measure Success 

Compensation & Compliance

The posted salary reflects CCMSI’s good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.

CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.

CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws.

Visa Sponsorship: CCMSI does not provide visa sponsorship for this position.ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.

Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.

Our Core Values

At CCMSI, we believe in doing what’s right—for our clients, our coworkers, and ourselves. We look for team members who:

• Lead with transparency We build trust by being open and listening intently in every interaction.
• Perform with integrity We choose the right path, even when it is hard.
• Chase excellence We set the bar high and measure our success. What gets measured gets done.
• Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own.
• Win together Our greatest victories come when our clients succeed. 

 We don’t just work together—we grow together. If that sounds like your kind of workplace, we’d love to meet you.