Healthcare Client Resolution Specialist (On-Site)

WEB-TPA, Inc.; San Antonio (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

WebTPA, a GuideWell Company, is seeking an entry-level Client Resolution Specialist in San Antonio, TX to handle inbound calls from providers and members, focusing on resolving client-related issues and escalating complex cases with expert guidance.

You will be the primary contact for claims and service questions for assigned accounts, using systems to track inquiries, and supporting the Customer Service team while collaborating with Benefit Consultants on employer group issues.

Qualifications

• 1+ years related work experience in customer service.
• Knowledge of CPT and ICD-10 coding, COBRA, HIPAA, and benefits coordination.
• Concise written and oral communication skills.
• Ability to travel to multiple locations for work (travel expectations mentioned).

Responsibilities

• Provide standard client support for claims and customer service issues for assigned accounts.
• Serve as main customer service contact to resolve issues and identify client needs proactively.
• Utilize systems to track all assigned client questions or concerns; manage calls and queues.
• Provide expert level assistance to members with complex or escalated issues.
• Collaborate with Benefit Consultants to resolve employer group issues and locate network providers.
• Assist with claim appeals, benefit questions, and special projects as needed.

Skills

Customer service

Communication

Conflict resolution

MS Office

Relationship building

Education

High school diploma or GED

Tools

MS Office Suite

Job description

WebTPA, a GuideWell Company, is seeking an entry-level Client Resolution Specialist in San Antonio, TX to handle inbound calls from providers and members, focusing on resolving client-related issues and escalating complex cases with expert guidance.

You will be the primary contact for claims and service questions for assigned accounts, using systems to track inquiries, and supporting the Customer Service team while collaborating with Benefit Consultants on employer group issues.