Support Services Specialist

Yuzu; Oregon; Ibrido; USD 48.000 - 55.000; Tempo pieno

Vantaggi offerti da questo lavoro

Equity opportunities

Competitive salary

Health benefits

401K with employer matching

Career growth

Descrizione del lavoro

Yuzu is a tech-enabled TPA building innovative health plans and providing high-quality support. The Member and Provider Experience Specialist is the first point of contact, resolving benefit, eligibility, and claims inquiries with empathy and accuracy.

You will handle inbound calls, educate on plan policies and digital tools, and collaborate with internal teams to resolve complex questions. Remote capabilities and growth opportunities are emphasized.

Competenze

• Experience in customer-support or contact-center environments is preferred.
• Knowledge of HIPAA guidelines and privacy requirements is advantageous.

Mansioni

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

Conoscenze

Empathy and active listening

Accuracy & attention to detail

Workload prioritization

Strong communication

Problem solving & critical thinking

Dependability

Team-oriented mindset

Descrizione del lavoro

Who are we?Yuzu is a tech-enabled, vertically integrated Third Party Administrator (TPA) that powers innovative health plans centered on care navigation, capitated primary care, and real-time payments. Unlike traditional TPAs, we partner closely with plan designers who serve as care navigators, contract negotiators, and sales teams for the uniquely tailored plans they create.We currently support thousands of employees and differentiate ourselves by helping new models of healthcare delivery come to life — enabling new ways to access and pay for care through health care coverage.Our goal is simple: make it easy for any business to build and manage a custom health plan. We do this by efficiently processing claims, ensuring regulatory compliance, and building technology that enables custom payment flows and seamless collaboration across stakeholders. Equally important, we provide our members with high-quality support to ensure they have the guidance and assistance they need at every step of their healthcare journey.As we continue to grow, we're excited to welcome another talented Support Team member to help us continue delivering exceptional service and innovation.

The Role:

The Member and Provider Experience Specialist serves as the first point of contact for members and healthcare providers, delivering high-quality, compassionate, and solution-oriented support over the phone. This role is responsible for resolving benefit, eligibility, and claims-related inquiries while ensuring an exceptional service experience for all stakeholders.

• 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.
• Play a critical role in evolving and strengthening our Support team as we scale and take on new challenges

Who We're Looking For:

We're seeking a motivated, ethical, and compassionate individual who thrives in a fast-paced, detail-oriented environment and is passionate about doing the right thing and making a difference.

Core Competencies:

• Empathy and active listening
• A strong commitment to accuracy and attention to detail
• The ability to prioritize workload effectively in a fast-paced environment
• Strong communication skills
• Problem-solving and critical thinking
• Dependability and accountability
• Team-oriented mindset

What Will Make You Stand Out:

• Experience with innovative health insurance plan designs, including Reference-Based Pricing (RBP), cash payment models, and employer-sponsored Direct Primary Care
• Familiarity with HIPAA, CMS, or managed care guidelines
• Bilingual skills (especially Spanish) are a plus

Why Join Us:

• Equity opportunities
• Competitive Salary
• Approximately $48-$55k in annual salary depending on experience, location, and desired equity
• Health benefits
• 401K with Employer matching
• Career growth and development opportunities
• Remote capabilities
• Work Hours will be Monday - Friday 9am - 6pm EST
• We are a high-trust team with radically high transparency and autonomy

Our Interview Process:

If you're selected for an interview, here's what you can expect:

• Initial 30-45 minute video conversation with Support Operations Leadership
• Follow-up conversation with members of the broader Operations Leadership team
• Take-home assignment (approx. 2 hours) designed to reflect real on-the-job work
• Reference checks with 1-2 individuals you provide
• Possible onsite visit to our NYC office, depending on your location and role expectations