Employer Service Rep - LHB

Luminare Health Benefits Inc.; United States; Remote; USD 42,000 - 79,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) savings plan

Pension plan

Paid time off

Paid parental leave

Disability insurance

Life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Job summary

Luminare Health is seeking a claims resolution specialist to work with external customers to resolve claim and customer service issues initiated by clients. The role requires researching issues and delivering recommendations for process improvements.

You will communicate with clients, Operations and Client Management, and track outcomes to prevent recurrence and ensure quality support for our members.

Qualifications

• High School diploma or GED equivalent.
• Minimum five or more years claim processing/health insurance industry experience.
• Ability to work in a fast-paced, customer service driven environment.
• Excellent verbal and written communication skills.
• Ability to research topics, succinctly summarize findings and develop recommendations.
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers.
• Solid understanding of ERISA and DOL regulations.
• Ability to read, analyze and interpret SPDs.
• Flexible; open to continued process improvement.
• Self-directed with minimal supervision.
• Good leadership, organizational and interpersonal skills.
• Demonstrated critical thinking skills.
• Ability to handle problems across varying situations and reach resolution.
• Ability to learn new/proprietary systems and adapt to different platforms.

Responsibilities

• Work with external customers to resolve claim and customer service issues.
• Research and resolve issues; suggest process improvements.
• Communicate with clients, Operations and Client Management; coordinate actions.
• Track and monitor issue outcomes and follow up as needed.

Skills

Customer service

Verbal communication

Written communication

Problem solving

Leadership

Team collaboration

MS Excel

MS Word

Research skills

Education

High School diploma

Bachelor’s degree

Tools

MS Excel

MS Word

Job description

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success. We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.

Job Summary

This position is responsible for working with external customers to resolve claim and customer service issues initiated by clients or Client Management. Responsibilities include research and resolution of issues; recommendations for improvement of processes and procedures to eliminate recurrence of issues; communication with clients, Operations and Client Management; and tracking/monitoring of issues.

Required Job Qualifications

• High School diploma or GED equivalent
• Minimum five or more years claim processing/health insurance industry experience
• Ability to work in a fast-paced, customer service driven environment
• Excellent verbal and written communication skills
• Ability to research various topics, succinctly summarize findings and develop a recommendation
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
• Solid understanding of ERISA and DOL regulations
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
• Flexible; open to continued process improvement
• Self-directed individual who works well with minimal supervision
• Good leadership, organizational and interpersonal skills
• Demonstrated critical thinking skills
• Ability to effectively deal with problems in varying situations and reach resolution
• Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word

Preferred Job Qualifications

• Bachelor’s degree
• Good presentation skills
• Experience presenting and explaining benefits to a group or one-on-one

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

EEO Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace.

Pay Transparency Statement

At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work.

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• plus other incentives

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range: $42,200.00 - $79,300.00 Exact compensation may vary based on skills, experience, and location.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned.

All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.