Remote Member & Provider Experience Specialist

Yuzu Health; United States; Remote; USD 48,000 - 55,000; Full time

Benefits offered by this job

Equity opportunities

Competitive Salary

Health benefits

401K with Employer matching

Job summary

Yuzu Health is seeking a Member and Provider Experience Specialist to be the first point of contact for members and healthcare providers. You will deliver high-quality, compassionate support over the phone and resolve benefits, eligibility, and claims inquiries with a focus on an exceptional service experience.

You will educate users on plan policies, digital tools, and resources, escalate when needed, and collaborate across internal teams to improve support as the company scales.

Qualifications

• Experience applying HIPAA guidelines and protecting patient information.
• Ability to understand and explain benefits, eligibility, and claims processes.
• Familiarity with health insurance plan designs and care navigation concepts.
• Strong attention to detail and accuracy in every interaction.

Responsibilities

• Answer inbound calls from members and providers in a professional and courteous manner.
• Provide accurate information regarding benefits, eligibility, claims status, authorizations, and network participation.
• Research and resolve complex inquiries by collaborating with internal departments.
• Educate members and providers on plan policies, digital tools, and available resources.
• Escalate issues as appropriate to ensure timely resolution.
• Maintain confidentiality and adhere to HIPAA guidelines.
• Meet or exceed performance metrics related to call quality, timeliness, and customer satisfaction.

Skills

Empathy & listening

Accuracy & detail

Workload prioritization

Communication skills

Problem-solving

Dependability & accountability

Team-oriented mindset

Job description

Yuzu Health is seeking a Member and Provider Experience Specialist to be the first point of contact for members and healthcare providers. You will deliver high-quality, compassionate support over the phone and resolve benefits, eligibility, and claims inquiries with a focus on an exceptional service experience.

You will educate users on plan policies, digital tools, and resources, escalate when needed, and collaborate across internal teams to improve support as the company scales.