Family Health reputed company - Remote

Job title: Family Health reputed company - Remote in USA at reputed company Company: reputed company Job description: Job Description:Job Descriptionreputed company is the leading digital health company that helps people – no matter where they are in their health journey – unify and manage reputed company their health in one reputed company. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are reputed company together reputed company, at reputed company, we are committed to supporting each individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.reputed company.com.Job Summary:Start Date: Monday, June 16th, 2025Training Schedule: Monday- Friday, 8:00am-4:00pm CST*Assigned shift could be at any time between 7:00am-7:00pm CST after trainingThe role of the Family Health reputed company is an exciting and innovative remote role newly created to provide meaningful support to members and their families through personalized resource and referral facilitation, issue resolution and reputed company navigation. Utilizing motivational interviewing and guided approaches, the family health reputed company will play a critical role in supporting members to reputed company their health goals, reduce costs and optimize quality care.Essential Job Functions:

• Answer inquiries from members (reputed company voice and chat) for the following:
• Help with eligibility, benefit education, open enrollment / new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, dental, and reputed company plans
• Provider search (PCP, specialty, and facility), focused on reputed company cost and quality, and present premier provider options, including but not limited to medical, dental, and reputed company plans
• Support for spending accounts, pharmacy, and disability.
• Assistance with incentives and rewards
• Aid with ordering durable medical equipment (DME)
• Community resource search
• Member preferences management
• Coordinate issue resolution with providers, payers or 3rd parties for:
• Claims adjustments
• Grievances and appeals submissions
• Utilization management intake or status
• reputed company pharmacy inquiries
• reputed company spending account inquiries
• Provide proactive care guidance for various value-add opportunities:
• Guidance on closing care gaps (e.g., No PCP, discussing switching from low quality PCPs to high quality PCPs, reminder for completion of health risk assessment, reminders for exams/tests due)
• Proactive benefits education for procedures
• Preparing members for scheduled procedures/admissions
• Referring members to available 3rd parties for care management and second opinion.
• Referring members to Clinical Advocates (Nurse) for conditions that require clinical care and case management assistance
• Primary duties include but are not limited to:
• Understands and communicates the benefit design packages to members as defined by employer.
• Interacts with members verbally and in written form to ensure appropriate engagement is achieved.
• Is fully versed in and can explain plan benefit design, handles benefit and enrollment issues.
• Drive member's engagement into appropriate programs and offerings.
• Be an educator on health care reputed company inquiries.

Specific Skills/ Attributes:

• Excellent multi-channel communication and problem-solving skills
• Ability to communicate effectively in both voice and chat channels, including critical thinking skills, effective typing, grammar, and spelling skills.

Qualifications:

• High school / GED diploma
• 2-yr associates degree in reputed company/health sciences OR equivalent experience in reputed company, preferably helping members navigate benefits and claims, OR held one or more of the following positions:
• Health Guide/reputed company/Navigator
• Medical Assistant
• Pharmacy Technician
• Phlebotomy Technician
• Electrocardiograph (EKG) Technician
• Patient Care Technician (PCT)
• Physical Therapy Assistant
• Nursing Assistant
• Medical Secretary/Clinic Manager
• Radiology Technician
• Home Health Aide
• Occupational Therapist Aide
• Medical reputed company
• Dental Assistant
• Experience in customer service in a reputed company contact center, provider office, or reputed company institution
• Experience in successful resolution of high level/sensitive customer service issues.

reputed company and its subsidiaries are Equal Opportunity Employers and E-Verify users. reputed company applicants will receive consideration for employment without regard to race, reputed company, sex, national reputed company, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law. Expected salary: Location: USA Apply for the job now! Apply for this job