Transplant Benefit Specialist
About The Position
Transplant Benefit Specialist Location : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual/ work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law Hours: Training is Monday through Friday from 8:30 a.m. to 5:00 p.m. EST. Upon completion of training, the schedule will transition to either Wednesday through Sunday or Thursday through Monday. Shifts will be eight hours per day and scheduled between 7:00 a.m. and 4:00 p.m. EST. The Transplant Benefit Specialist is responsible for ensuring accurate transplant benefit administration for all lines of business. Interfaces daily with providers and members to resolve benefit issues and provide education where needed. Responsible for analyzing components of benefits and alerting management of risks. How you will make an impact: Interprets benefits and interfaces with members and providers to give benefit information. Prepares individual benefit quotes for members and providers for transplant benefits. Identifies high risk cases and alerts management. Interfaces with internal and external representatives on benefit issues. Creates new cases in the Medical Management System with accurate benefit, group and provider information. Creates Case Management Folders and determines initial acuity level of case.
Requirements
- Requires HS diploma or equivalent and a minimum of 3 years related experience; or any combination of education and experience which would provide an equivalent background.
Nice To Haves
- Strong knowledge of healthcare, benefits and medical terminology
- Ability to explain complex medical and benefits information
- Strong attention to detail
- Ability to maintain professionalism and composure in sensitive conversations
Responsibilities
- Ensuring accurate transplant benefit administration for all lines of business
- Interfaces daily with providers and members to resolve benefit issues and provide education where needed
- Analyzing components of benefits and alerting management of risks
- Interprets benefits and interfaces with members and providers to give benefit information
- Prepares individual benefit quotes for members and providers for transplant benefits
- Identifies high risk cases and alerts management
- Interfaces with internal and external representatives on benefit issues
- Creates new cases in the Medical Management System with accurate benefit, group and provider information
- Creates Case Management Folders and determines initial acuity level of case
Benefits
- Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs (unless covered by a collective bargaining agreement)
- medical, dental, vision, short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs and financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
