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About the role
Key responsibilities & impact- Design member solutions for clients
- Engage directly with internal operational departments and assist clients’ Human Resources team members
- Execute proactive member issue escalation resolution strategies
- Manage and troubleshoot Client EDI files for eligibility
- Serve as concierge support and immediate escalation resource for customer service representatives and claims examiners
- Research claims where applicable
- Conduct outbound proactive outreach to members
- Resolve member issue escalations routed through member calls or HR Benefits leadership
- Triage and escalate member issues to the necessary department when appropriate
- Engage with members to ensure previous issues have been resolved in a timely manner
- Support members and providers with out-of-network facility services and provider billing challenges
- Use systems to track complaints and resolutions
- Provide basic reporting and analytics demonstrating service level performance for clients
- Work cross-functionally with claims, customer service, analytics, and clinical teams
Requirements
What you’ll need- 1+ years related work experience
- Related Bachelor’s degree or additional related equivalent work experience from an accredited university
- Preferably in Business, communications or experience working the medical insurance field
- Strong proficiency with Microsoft Office
- Strong verbal and written communication skills; ability to tailor communications based on audience and business objectives
- Comfortable working and communicating at very high levels across operational areas and working in cross-functional teams
- Maintain confidentiality and observe HIPAA requirements
- Strong customer service skills
- Ability to work independently/autonomously and proactively as well as collaboratively as a member of a team
- Must thrive in a team environment; team success will be heavily emphasized
- Must be a self-starter with the ability to identify problems/issues and offer workable solutions
- Ability to prioritize or seek information on how to best prioritize projects
- Project confidence, high energy, enthusiasm, and high regard for client advocacy and service
- One to three years’ experience in the health insurance administration industry a plus
Benefits
Comp & perks- Medical, dental, vision, life and global travel health insurance
- Life insurance
- Short- and long-term disability programs
- Leave programs to support personal circumstances
- 401(k) includes employer contribution match
- Paid time off, volunteer time off, and 11 holidays
- Additional voluntary benefits options available
- Comprehensive wellness program