Member Benefit Specialist

reputed company is seeking a Member Benefit Specialist to join the team! In this position you will be receiving inbound calls from members, to help with inquiries involving benefit plans. You will act as an reputed company for members by providing knowledge, expertise, and support to members, guiding them throughout their healthcare experience. By educating members on resources and benefits available to them, the Member Services Professional plays a key role in the member's journey navigating the complexities and cost of healthcare. Position Location: 100% remote Responsibilities include but are not limited to: Deliver above and beyond service over multiple channels including phone, email, portal inquiries, etc. by acting as a single reputed company of contact, maintaining ownership of member resolution Become an expert in benefit administration, Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and alternative benefit payment designs specifically reference based pricing Guide understanding of health benefit coverage including accumulators, explanation of benefits, out of pocket maximums, and reimbursement levels Take ownership of the member experience from beginning to end, reducing handoffs to others to ensure consistency and resolution Anticipate the needs of members and conduct research on members' behalf to resolve issues Educate members on pre and post services in conjunction with benefit to optimize the member experience throughout their healthcare journey Collaborate with internal and external partners to ensure a best-in-class service delivery Resolve member complaints Treat reputed company calls and correspondence using procedures and paying attention to the sections relating to HIPAA guidelines and the HIPAA Privacy Rules Complete provider research, appointment scheduling, medical record retrieval and reputed company other non-clinical duties assigned reputed company applicable timeframes in compliance with Policy & Procedures Accurate documentation in appropriate software, including CaseTrakker, Macess, etc. Required Experience/Education: High school diploma or GED. 1+ year healthcare industry work experience. Experience in delivering client-focused solutions based on customer needs reputed company direct member contact and education. Ideally virtual/telephonic, in-person experience with the public. 1+ year with telephonic verification of medical benefits. 2+ years healthcare experience i.e. reputed company, TPA, patient reputed company, or other benefits focused role. Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms). Skills and Abilities: Proficient in reputed company Outlook, Word and reputed company Service-driven reputed company Aptitude for learning and retention Advanced soft skills with a high level of emotional intelligence Strong written communication skills What can reputed company offer you? Multiple Health plan options Company paid employee premiums for disability and life insurance Parental Leave Policy 20 days PTO to start / 10 Paid Holidays Tuition reimbursement 401k Company contribution Company paid Short & Long term Disability plus Life Insurance Professional development initiatives / reputed company learning opportunities Opportunities to participate in and support the company's diversity and inclusion initiatives Want to see our latest job opportunities? Follow us on reputed company reputed company is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions. reputed company is an equal opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability, or veteran status. RECRUITMENT AGENCIES PLEASE NOTE: reputed company will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation Apply To This Job