Member Experience Specialist: Client Concierge & Solutions

WEB-TPA, Inc.; Walker (MI); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical, dental, vision, life and well

Global travel health insurance

401(k) with employer match

Paid time off

Volunteer time off

11 holidays

Wellness program

Job summary

WebTPA, a GuideWell Company, seeks a Member Experience Specialist to improve member and client experiences within the Account Management team. This onsite role in Walker, MI, collaborates across claims, customer service, analytics, and clinical teams to deliver high-quality, cost-effective service.

Ranked for strong communication, HIPAA compliance, and proactive problem solving, the MES will drive end-to-end member support and escalation handling to protect plan health care spend.

Qualifications

• 1+ years related work experience.
• Bachelor’s degree or related equivalent in Business, communications or health insurance.
• Proficiency with Microsoft Office.
• Strong verbal and written communication skills.
• Comfortable working across operational areas and cross-functional teams.
• Maintain confidentiality and HIPAA compliance.
• Strong customer service skills.
• Ability to work independently/autonomously and proactively.
• Thrive in a team environment and value client advocacy.
• Self-starter with problem identification and solution orientation.
• Ability to prioritize projects and manage time efficiently.
• High energy, initiative and professional demeanor for client relations.

Responsibilities

• Design member solutions for clients in coordination with internal departments.
• Implement proactive member issue escalation and resolution strategies.
• Manage and troubleshoot Client EDI files.
• Serve as concierge support for members and escalated inquiries, researching claims when needed.
• Provide outbound member outreach and ensure timely issue resolution with HR Benefits leadership.
• Track complaints and resolutions using the available systems.
• Prepare basic reporting and analytics on service levels for clients.

Skills

Microsoft Office

Communication skills

HIPAA compliance

Customer service

Cross-functional

Teamwork

Independence

Prioritization

Self-starter

Problem solving

Project confidence

Education

Bachelor’s degree in Business/Communications or health insurance

Job description

WebTPA, a GuideWell Company, seeks a Member Experience Specialist to improve member and client experiences within the Account Management team. This onsite role in Walker, MI, collaborates across claims, customer service, analytics, and clinical teams to deliver high-quality, cost-effective service.

Ranked for strong communication, HIPAA compliance, and proactive problem solving, the MES will drive end-to-end member support and escalation handling to protect plan health care spend.