Member Experience Leader - Onsite in MI

GuideWell; Walker (MI); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Medical, dental, vision, life and ad-h

401(k) with employer match

Paid time off and holidays

Wellness program

Disability programs

Job summary

WebTPA, a GuideWell Company, seeks a Member Experience Specialist to improve member experience by partnering with Account Executives and HR Benefits leaders, addressing escalated issues, and coordinating with claims, customer service, analytics, and clinical teams. The role is based onsite in Walker, MI, with typical hours 8am–5pm, Monday to Friday.

Requires 1+ year of related experience, a Bachelor's degree or equivalent, and strong communication and Microsoft Office skills to drive

Qualifications

• 1+ years related work experience.
• Bachelor’s degree or related equivalent work experience in Business, communications or health insurance field preferred.
• Strong proficiency with Microsoft Office.
• Strong verbal and written communication skills; ability to tailor communications based on audience and business objectives.
• Comfortable working across operational areas and cross-functional teams.
• Maintain confidentiality and observe HIPAA requirements.
• Strong customer service skills.
• Ability to work independently/autonomously and proactively as well as collaboratively.
• Must thrive in a team environment; team success emphasized.
• Must be a self-starter with ability to identify problems and offer workable solutions.

Responsibilities

• Design member solutions for clients, engaging with internal departments and client HR teams.
• Execute proactive member issue escalation resolution strategies.
• Eligibility management and troubleshooting of Client EDI files.
• Serve as concierge support for customer service reps and claims examiners; research claims where applicable.
• Outbound outreach to members and issue resolution coordination with Account Executive and client HR leadership.
• Triage and engage with members to ensure prior issues are resolved timely.
• Support members and providers on OON facility services and billing challenges.
• Utilize systems to track complaints and resolutions.
• Provide basic reporting and analytics demonstrating service level performance for clients.

Skills

Microsoft Office

Verbal and written communication

Customer service

Cross-functional collaboration

Self-starter/autonomous

Teamwork

Education

Bachelor’s degree or related equivalent work experience

Job description

WebTPA, a GuideWell Company, seeks a Member Experience Specialist to improve member experience by partnering with Account Executives and HR Benefits leaders, addressing escalated issues, and coordinating with claims, customer service, analytics, and clinical teams. The role is based onsite in Walker, MI, with typical hours 8am–5pm, Monday to Friday.

Requires 1+ year of related experience, a Bachelor's degree or equivalent, and strong communication and Microsoft Office skills to drive