Member Services Support Specialist

Imagine360, LLC; United States; Remote; USD 48,000 - 64,000; Full time

Benefits offered by this job

Health plan options

Company-paid disability & life保险

Parental Leave Policy

20 days PTO to start

10 Paid Holidays

Tuition reimbursement

401k Company contribution

Short & Long term Disability plus Life

Professional development initiatives

Diversity & inclusion initiatives

Job summary

Imagine360, LLC is seeking a Mission-driven Member Services Support Specialist to aid terminated accounts, guide balance bill defenses, and collaborate with our legal and external partners. This remote role centers on elevating member experience and timely resolutions.

Ideal candidates have 1+ year of member support, familiarity with billing or healthcare environments, and strong communication skills. We offer comprehensive health plans, tuition reimbursement, and robust professional development

Qualifications

• 1+ years of related member support experience.
• Experience in billing, insurance, healthcare or legal environments is a plus.
• High school diploma or GED; Some College is preferred.

Responsibilities

• Manage assigned member caseload via proactive advocacy model with a focus on elevating the member experience and promoting engagement.
• Provide specialized focus on members of terminated clients for balance bill run-out.
• Assist members with balance bill issues using independent critical thinking and effective communication.
• Coordinate elevated internal and external issue resolution; act as point person for inquiries and ensure timely remediation.
• Facilitate communication with members, clients, medical providers, and legal representation.
• Analyze billing activity to make strategic recommendations for balance bill settlement.
• Build rapport with members and internal stakeholders.
• Track status and resolution of inquiries; maintain documentation and follow-ups.
• Collaborate to address service issues and process improvements.
• Apply knowledge of HIPAA regulations.

Skills

Member support experience

Billing/healthcare experience

HIPAA regulations

Independent decision-making

Excellent communication

Education

High school diploma or GED

Some College

Tools

Outlook

Microsoft Word

Excel

Job description

Imagine360 is seeking a Member Services Support Specialist

The Member Services Support Specialist (MS SS) provides specialized support and education to members of terminated accounts while fulfilling the mission of Imagine360. The MS SS guides and supports the member through the balance bill defense process while working closely with our legal team and external stakeholders to facilitate timely issue resolution and ensure a positive member experience.

Position Location

100% remote

Responsibilities include but are not limited to:

• Manage assigned member caseload via proactive advocacy model with a focus on elevating the member experience and promoting engagement.
• The MSS provides specialized focus on members/employees of terminated clients for run-out balance billing.
• Apply independent critical thinking and acumen to assist members with their balance bill issues and inquiries with a focus on influencing a positive member experience
• Coordinate elevated internal and external member issue resolution with confidence and a sense of urgency. Act as point person for member inquiries, issues and concerns. Direct, quarterback and ensure timely issue resolution and remediation.
• Facilitate, influence and coordinate communication with members, clients, medical providers, in-house and external legal representation.
• Analyze billing activity and associated financial impacts to make strategic recommendations for balance bill settlement.
• Establish and build a strong rapport with members and internal counterparts.
• Track status and resolution of member inquiries and issues.
• Maintain accurate and complete documentation and follow-up diaries during all stages of the process.
• Collaborate with other internal stakeholders to address service issues and process/systemic enhancement opportunities.
• Apply strong knowledge of HIPAA regulations.

Required Experience/Education:

• High school diploma or GED.
• Some College
• 1+ years of related member support experience;
• Experience in billing, insurance, healthcare or legal environments a plus

Skills and Abilities:

• Proficiency in Microsoft Outlook, Microsoft Word, Excel and internet navigation
• Excellent written and verbal communication skills
• Advanced problem resolution skills
• Ability to make independent decisions and apply critical thinking

What can Imagine360 offer you?

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.