Customer & Client Resolution Specialist

GuideWell • San Antonio, TX

8h • Onsite

About The Position

Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. What is your impact? The Client Resolution Specialist is an entry level position that maintains responsibilities similar to a Customer Service Representative and is responsible for handling inbound customer calls from both providers and members but is more highly focused on resolving client-related issues and providing expert-level resolution to complex cases. This may include partnering with Benefits departments in trying to solve complex issues.

Requirements

• 1+ years related work experience in customer service
• High school diploma or GED
• Knowledge in the healthcare industry including CPT and ICD-10 coding, COBRA, HIPAA, pre-existing conditions, and coordination of benefits
• Concise written and oral communication skills required, including the ability to deal with conflict.
• Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers.
• Knowledge of all MS Office products.
• Must possess proven judgment, decision-making skills and the ability to analyze.

Responsibilities

• Provide standard client support: Primary client contact for claims and customer service issues and question for assigned accounts.
• Main customer service contact to resolve issues and identify customer needs on a pro-active basis.
• Utilize systems to tract all assigned clients questions or concerns.
• Assisting with customer service phone calls and queues as assigned.
• Provide expert level of assistance to members who have complex or escalated issues that have not been successfully resolved by normal means
• Identify members who have high claim volumes or excessive calls to customer service, which may be an indication that they need help understanding their plan or help with finding solutions
• Work directly with the Benefit Consultant for the employer group, to resolve claim or customer service issues.
• Other responsibilities include researching claim appeals, researching benefit questions, and locating network providers.
• Provide direction and training to client-dedicated Customer Service Team staff
• Provide instruction and training to Customer Service Team when directed by the employer group or the Customer Service Manager.
• Assisting with assigned special projects.

Benefits

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, Short- and long-term disability programs
• Flexible schedules after training + future WAH options!
• Leave programs to support personal circumstances.
• Retirement Savings Plan includes employer contribution and employer match
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available and a comprehensive wellness program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED