Member Experience Specialist

GuideWell • San Antonio, TX

10d • 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. Location: Ability to work onsite highly preferred at: 19100 Ridgewood Parkway San Antonio TX 78259 6535 SH 161 Irving Texas 75063 What is your impact? The Member Experience Specialist will work independently to seek to improve the member experience for their dedicated client by engaging with members to identify and uncover needs and providing solutions that will enhance their health and wellness through phone and digital communication. They should proactively identify potential issues ensuring the organization is consistently providing exceptional member service. What Will You Be Doing: Relationship management: -Responsible for managing member solutions for a dedicated client while engaging directly with client’s Human Resource’s team members. Member service: -Provide dedicated VIP-level service to priority members enrolled in the health plan. -Deliver personalized assistance for high needs members for non-standard inquires. -Inbound and Outbound proactive outreach to members, and to client's HR team. -Resolve member issues routed through member calls -Triage and escalate member issues to the necessary department when appropriate, and to various vendors, for a seamless experience to best service the client. -Engage with members to ensure previous issues have been resolved in a timely manner -Support members and providers to the best experience in addressing OON facility services, provider billing challenges -Maintain good rapport with physicians, healthcare facilities, clients, providers and internal and external stakeholders Utilize systems to track complaints and resolutions Attend regular client meetings, upon request, to provide high quality client satisfaction.

Requirements

• 1+ years related work experience.
• Related Bachelor’s degree or additional related equivalent work experience
• 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.
• 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

Nice To Haves

• One to three years’ experience in the health insurance administration industry a plus.

Responsibilities

• Responsible for managing member solutions for a dedicated client while engaging directly with client’s Human Resource’s team members.
• Provide dedicated VIP-level service to priority members enrolled in the health plan.
• Deliver personalized assistance for high needs members for non-standard inquires.
• Inbound and Outbound proactive outreach to members, and to client's HR team.
• Resolve member issues routed through member calls
• Triage and escalate member issues to the necessary department when appropriate, and to various vendors, for a seamless experience to best service the client.
• Engage with members to ensure previous issues have been resolved in a timely manner
• Support members and providers to the best experience in addressing OON facility services, provider billing challenges
• Maintain good rapport with physicians, healthcare facilities, clients, providers and internal and external stakeholders
• Utilize systems to track complaints and resolutions
• Attend regular client meetings, upon request, to provide high quality client satisfaction.

Benefits

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, Short- and long-term disability programs
• 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
• Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 5,001-10,000 employees