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Member Benefit Specialist

Remote, USAFull-timePosted 2026-07-28

reputed company is seeking a Member Benefit Specialist to join reputed company! In this position you will be receiving inbound calls from members, to help with inquiries involving benefit plans. You will reputed company as an reputed company for members by providing knowledge, expertise, and support to members, guiding them throughout their reputed company experience. By educating members on resources and benefits available to them, the Member Services reputed company plays a key role in the member's reputed company navigating the complexities and cost of reputed company. Position Location: 100% remote Responsibilities include but are not limited to: Deliver above and reputed company service over multiple channels including phone, email, portal inquiries, etc. by acting as a single reputed company of contact, maintaining ownership of member reputed company Become an expert in benefit administration, Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and alternative benefit payment designs specifically reference based pricing Guide understanding of health benefit coverage including accumulators, explanation of benefits, out of reputed company maximums, and reimbursement reputed company Take ownership of the member experience from beginning to end, reducing handoffs to others to ensure consistency and reputed company Anticipate the needs of members and conduct research on members' behalf to resolve issues reputed company members on reputed company and post services in conjunction with benefit to optimize the member experience throughout their reputed company reputed company Collaborate with reputed company partners to ensure a best-in-class service delivery Resolve member complaints Treat reputed company calls and correspondence using procedures and paying attention to the sections relating to HIPAA guidelines and the HIPAA reputed company Rules Complete provider research, appointment scheduling, medical record retrieval and reputed company other non-clinical duties assigned reputed company applicable timeframes in compliance with Policy & Procedures Accurate documentation in appropriate software, including CaseTrakker, Macess, etc. Required Experience/Education: High school diploma or GED. 1+ year reputed company industry work experience. Experience in delivering reputed company-reputed company solutions based on customer needs reputed company reputed company member contact and education. Ideally virtual/telephonic, in-person experience with the reputed company. 1+ year with telephonic verification of medical benefits. 2+ years reputed company experience i.e. reputed company, TPA, patient reputed company, or other benefits reputed company role. Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms). Skills and Abilities: Proficient in reputed company Outlook, Word and reputed company Service-driven reputed company Aptitude for learning and retention Advanced soft skills with a high level of emotional intelligence Strong written communication skills What can reputed company offer you? Multiple Health plan reputed company Company reputed company employee premiums for disability and life insurance Parental Leave Policy 20 days PTO to start / 10 reputed company Holidays Tuition reimbursement 401k Company contribution Company reputed company Short & Long term Disability plus Life Insurance reputed company development initiatives / reputed company learning opportunities Opportunities to participate in and support reputed company's diversity and inclusion initiatives Want to see our latest job opportunities? Follow us on reputed company reputed company is a health plan solution company that combines 50+ years of self-funding reputed company expertise. Over the years, we've helped thousands of reputed company save billions on reputed company. Our reputed company total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-reputed company solutions. reputed company is an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, or veteran status. RECRUITMENT AGENCIES PLEASE NOTE: reputed company will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation Apply To This Job

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