What are the responsibilities and job description for the Onsite Member Services Representative position at Health Care Service Corporation?
At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job SummaryThis position is responsible for working onsite at the client's office/facility - up to 5 days a week for the entire workday. Minimal working hours will be spent in a work-from-home office or in a client office/facility. The associate meets face-to-face with members to resolve claim issues, assist with understanding of benefits, assist with Open Enrollment activities, and support the Human Resources team with the benefits offered to its employees. The position also meets face-to-face with the client's Human Resources personnel as needed under the direction of the Client Manager. The associate must project a high level of professionalism as they are an onsite representation of Luminare Health to members and the client.Responsibilities include research and resolution of issues; recommendations for improvement of processes and procedures to eliminate recurrence of issues; professional and clear communication with members, clients, Operations and Client Management; and tracking/monitoring of issues.
This is a remote position; however, candidates must reside in Atlanta, Georgia, or the surrounding area.
Job Description:
- Meet face-to-face with members regarding their benefit questions.
- Research and resolve claim inquiries initiated by members, clients and/or brokers.
- Provide verbal (or written) status updates and explanations to members, clients, brokers or Client Manager regarding issues.
- Follow-up regularly on outstanding inquiries to ensure timely resolution and member/client satisfaction.
- Appropriately notify, refer, or escalate inquiries.
- Track issues and document resolution.
- Recommend process improvements, procedural changes, or other actions to eliminate trends/issues.
- Develop and maintain relationships with select members, clients, Client Management and Claims & Customer Service personnel.
- Complete special client requests or projects, as directed
- Other duties as needed/assigned
Job Requirements:
- Ability to travel to the client(s) office/facility on a regular basis.
- Prior claim processing/health insurance experience
- Ability to work in a fast-paced, client centric environment
- Excellent verbal and written communication skills
- Ability to research and summarize findings and develop solutions or recommendations for resolution
- Ability to work effectively with employees/members, providers, clients and various levels of staff
- Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Flexible; open to continued process improvements
- Self-directed individual who works well with minimal supervision
- Good leadership, organizational and interpersonal skills
- Demonstrated critical thinking skills
- Ability to effectively handle varying situations and reach resolution
- Ability to adapt to various system platforms, and to effectively use MS Excel/Word
- Good presentation skills
- High School diploma or GED equivalent
Preferred:
- Bachelor's degree
- Experience presenting and explaining benefits to an individual or group
#LI-Remote
#LI-LF1
#LI-KT1
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
EEO Statement:We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified 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 legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan,pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package forassociates.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.
Min to Max Range:
$41,400.00 - $77,700.00
Salary : $41,400 - $77,700
