Independent Member Advocate - Hybrid (Medfield, MA)

Are you looking to accelerate your career without having to hide your authentic self - a place where you can be you? A career that’s making a bigger impact on the world? At OneDigital, we are on a mission to help people do their best work and live their best lives. From the services we offer to the way we show up for each other each day, we are fueling dreams, achieving big goals, and embracing each other’s truest selves.

We understand that pursuing a new job is a big deal. Maybe you’re afraid you won’t fit in. Well, here’s the good news. For us, the days of “fit in to get in” are over and being different is not a barrier to getting ahead. Greatness comes in all shapes, sizes, colors, and experience levels. If you are looking for a people-first culture that is wired for growth, driven to serve, and totally committed to having your back, give us a shot. Your best life awaits.

Our Newest Opportunity:

The Independent Member Advocate will utilize advanced insurance skills to provide favorable relationships with customers, groups and clients through the prompt, accurate and courteous resolution of benefit and eligibility inquiries.

Essential Duties and Responsibilities (include but are not limited to):

• Provide concierge level customer service to clients and plan members for benefit questions and claim issues via phone and email. Questions may include understanding benefit plans, educating members on available resources, and resolving provider billing issues.
• Act as liaison between plan member, health care provider, pharmacy, insurance carrier and HR to resolve problems quickly and efficiently.
• Conduct research to provide resolution for our client and their employees benefit questions and provider billing issues
• Respond to plan member requests with 24 to 48 hours via the appropriate means of communication.
• Develop and retain relationships with plan members, insurance carrier representatives and healthcare providers.
• Verify eligibility and benefits for healthcare providers and inquiries regarding claim payments and remittances.
• Process Rx claims and if needed, adjust medical claims.
• Contributes to overall team goals and objectives through team participation and the sharing of individual skills and strengths.
• Other projects as requested or assigned
  
  

Qualifications, Skills and Requirements:

• 1 to 3 years’ experience in group benefits industry.
• 6 months or more member or provider call center experience required.
• Provider billing or coding experience is a plus.
• BA or BS degree or equivalent years of training and work experience
  
  

Education, Training and Experience:

• Empathetic, positive attitude with a desire to help our plan members
• Strong verbal and written communication skills
• Ability to prioritize and multitask in a fast-paced environment
• Ability to handle stressful situations
• Proficient with Microsoft Office products
  
  

Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company’s performance. We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs. You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts. To learn more, visit: www.onedigital.com/careers

OneDigital is an equal opportunity employer. Not only as a matter of standard, but to honor and celebrate our differences. We believe that the power of ONE starts with you. We are committed to cultivating and preserving a culture that celebrates diversity, insists on equity and inclusion, and connects us. Ensuring our people feel seen, valued, respected, and supported is fundamental to our core values and business goals.

OneDigital provides equal employment opportunities to all employees and applicants for employment regardless of their: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy (including childbirth, lactation and related medical conditions), national origin or ancestry, citizenship or immigration status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law (collectively, “protected characteristics”). A copy of the Federal EEO poster is linked here.

Pursuant to local Fair Chance Ordinances, we will consider qualified applications with arrest or conviction records for employment. For applicable candidates, the following ordinances are linked here to inform you of your rights as an applicant:

City and County of San Francsico

City of Los Angeles

County of Los Angeles

Employment decisions shall comply with all other applicable federal, state and city/county laws prohibiting discrimination in employment. OneDigital complies with all criminal history inquiry [or ‘ban the box’] laws in California, Connecticut, Colorado, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington.

In short, we believe in hiring the most qualified applicant for the position, regardless of background.

If you have questions about our hiring policies and practices, we would be happy to discuss upon receiving your application. We hope to welcome you to OneDigital and look forward to hearing from you.

Thank you for your interest in joining the OneDigital team!