Navigation Care Coordinator - Virtual

Alight Solutions•US-TX-Texas-Virtual, TX

2d•$42,000 - $45,000•Remote

About The Position

This is a virtual role seeking a member with healthcare coverage knowledge and customer service skills. The position involves handling customer calls, gathering information, and resolving issues. It requires attentive listening skills, empathy, and professionalism. Responsibilities include processing enrollment events, reviewing administrative concerns, counseling on available benefits, and assisting with eligibility questions.

Requirements

Possess excellent written and verbal communication skills, customer service and customer resolution skills, and critical thinking skills.
Possess organizational and time management proficiencies.
Able to recognize the need to change priorities to meet the business needs.
Able to work effectively in a team environment.
Able to have workstation that is free of noise and distractions.
Possess technology proficiency.
Access information using a computer and related components and peripherals.
Participate in training sessions and meetings.
Ability to be flexible with various shifts and possible overtime when business needs require.
2 years relevant experience in health plan benefits or associate’s (health care benefit-related field).
Possess Spanish speaking/ Bilingual experience.

Responsibilities

Handling inbound and outbound calls to assist with customer needs related to Health and Welfare benefits, including processing enrollments.
Educating customers on benefit plans and program options.
Utilizing tools to discuss premiums, coinsurance, copays, deductibles, and out of pocket expenses for health benefits.
Using excellent customer service skills with empathy and compassion to resolve complex customer needs while navigating multiple tools in a quick-paced environment.
Educating customers on plan provisions using Summary Plan Descriptions and other tools, including handling questions on COBRA and retirement.
Handling questions about COBRA, process enrollments, and connect customers to relevant benefits, resources, or programs.
Participating in ongoing healthcare training and adapting to new processes as needed.
Scheduling and completing appointments for Retirement, Annual Enrollment, and other special events.
Investigating identified issues by interacting with the health plan, provider, and other third parties as needed.
Utilizing excellent written communication skills to accurately record and summarize customer needs and actions.
Receiving coaching and feedback on performance and applying learnings.