Health Plan Member Experience Concierge

Leading Edge; New York (NY, TX); Hybrid; USD 32,000 - 36,000; Full time

Job summary

Leading Edge in New York seeks a Client Concierge Specialist to deliver high-touch, white-glove service to members, providers, and clients within a health insurance environment. You will guide members through their healthcare journey by offering personalized support on benefits, eligibility, claims, provider navigation, and issue resolution.

The role emphasizes ownership with empathy, proactive problem-solving, and collaboration to resolve inquiries efficiently while maintaining confidentiality

Qualifications

• High school graduate or equivalent; Associates or Bachelor's degree preferred.
• 2+ years of experience in customer service or call center handling escalations in healthcare, insurance, or TPA.
• Comfortable supporting multiple channels and adapting to dynamic workloads.
• Familiarity with call center metrics and quality standards; experience with claims processing, benefits, eligibility systems preferred.
• Experience with CRM systems or customer support platforms preferred.
• Experience handling escalations via emails and spreadsheets with timely resolution.
• Exposure to workforce management or scheduling tools.
• Solid knowledge of MS Word, Excel, Outlook, and PowerPoint.
• Clear, professional communication with internal and external customers.
• Ability to work both independently and in a team to achieve outcomes.

Responsibilities

• Serve as primary contact for inbound calls, emails, and digital inquiries from members and providers.
• Deliver concierge-level service by understanding member needs and providing tailored solutions.
• Assist members with benefits education, eligibility verification, and plan navigation.
• Guide members through claims inquiries, including status and explanation of benefits.
• Support provider searches, appointment coordination, and healthcare navigation.
• Research and resolve complex issues related to claims, billing, and coverage.
• Investigate and resolve disputes/escalations and provide research until resolution.
• Update and maintain progress records; communicate updates to stakeholders.
• Meet or exceed performance metrics including quality, accuracy, and member satisfaction.
• Deliver empathetic, professional communication and retention-focused support.

Skills

Customer service

Healthcare knowledge

Multichannel support

Communication

Problem solving

Documentation

Team collaboration

Confidentiality

Time management

Attention to detail

Education

High school diploma

Associates or Bachelor's degree preferred

Tools

MS Word

Excel

Outlook

PowerPoint

CRM systems

Job description

Leading Edge in New York seeks a Client Concierge Specialist to deliver high-touch, white-glove service to members, providers, and clients within a health insurance environment. You will guide members through their healthcare journey by offering personalized support on benefits, eligibility, claims, provider navigation, and issue resolution.

The role emphasizes ownership with empathy, proactive problem-solving, and collaboration to resolve inquiries efficiently while maintaining confidentiality