Health Benefits Representative (Customer Service)

Healthcare Customer Advocate (The Woodlands, TX or Lincolnshire, IL)

Our story starts with a simple universal truth: Every business is a people business. Our people are our greatest assets at Alight Solutions because People Matter! We strive for Excellence Every Day by collaborating with our clients and colleagues. At Alight, we Think Forward and we Act Now to shape the future of work and life for organizations, people and their families! Alight has 25 years of industry experience. Our success is fueled by the expertise of our people, and the strength of our proprietary and partner technology. Come join the leading technology-enabled HR and benefits service provider. Be Real with Alight and help us reimagine how people and organizations thrive.

Do you have a passion for helping others? Become a Healthcare Customer Advocate to make a difference in people’s lives!Our Advocates interact with customers every day, helping them navigate the complex health care system. As the primary point of contact for our clients’ employees, they help customers unravel complicated issues, connect to an employer program, or determine a plan to resolve an issue. Their knowledge of the health insurance and benefit plans helps them guide employees through their health care journey. If you’re a smart, empathetic and proactive health care expert, we’re looking for you to join our growing team!

Detailed Responsibilities

• Provide exceptional customer service through inbound & outbound calls with our customers, offering compassion and empathy
• Educate our customers on their available benefits, connecting them to resources that support their health care journey
• Assist customers with understanding their benefit options, such as during Annual Enrollment
• Actively listen to identify a customer’s needs
• Use probing questions to fully uncover a customer’s issue
• Coordinate with a Research Advocate to fully investigate and resolve a customer’s issues
• Fully own all customer interactions, including those done via phone, appointments, and virtual chat
• Act as an expert on your clients’ employer-sponsored benefits, tools, and resources
• Use problem-solving skills to recommend programs that meet a customer’s unique needs
• Summarize calls, program referrals, and research requests in the case management system
• Deliver a consistent, positive customer experience in a highly ethical and professional manner
• Identify and resolve barriers for customers attempting to access care
• Resolve customer needs or concerns related to:
• identification of in-network providers or facilities
• identification of prescription drug alternatives
• education on benefit plans or programs

Education & Certification

• 2 or 4 year college degree in a health-related field

OR

• 4+ years’ experience in health care or employer-sponsored benefits
• Active license in the following area a plus:
• In Texas – Life, Accident, Health & HMO License
• In Illinois- Life, Accident, Health & HMO License

Work Experience

• Detailed knowledge of health benefits, including PPO plans, High deductible, HSAs and HRAs
• Understanding of specific plan overages and exclusions in medical, prescription, dental, vision, and behavioral health/substance abuse
• Knowledge or experience in at least two of the following:
• Affordable Care Act
• Medical claim handling, processing and billing
• Health Savings Accounts
• Flexible Spending Accounts
• Carrier & medical provider interactions
• Carrier case management
• Medicare
• COBRA
• Experience with desktop/Windows navigation and keyboarding skills.
• Experience with MS Word, Excel, SharePoint, and Outlook

Qualifications

• Exceptional listening skills
• Excellent customer service expertise
• Aptitude to understand details of health insurance products and regulations
• Superb problem solving, critical thinking, and analytical skills
• Strong organizational and time management proficiencies
• Flexible and adaptable with a demonstrated ability to recognize the need to change priorities to meet the business needs.
• Ability to work independently while providing support in a team environment
• Strong written and verbal communication skills
• Ability to execute thorough and detailed documentation

Work Conditions

• Frequent computer use at a workstation for extended periods of time
• Participate in ongoing training sessions and meetings
• Ability to be flexible with various daytime shifts and possible overtime when business needs require
• Ability to coordinate phone time including making outbound calls and receiving inbound calls consecutively throughout the day

By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight’s employment policies. Background checks may include some or all of the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, fingerprint verification, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

At Alight, we believe that diversity should be visible, valued, and sustained throughout the organization. Alight provides equal treatment and employment opportunities to all employees and applicants for employment without regard to any protected status or other protected characteristic.

Alight does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state or local law. In addition, we take affirmative action to employ and advance in employment qualified minorities, women, disabled persons, disabled veterans and other covered veterans.

Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities, sincerely held religious beliefs, practices and observances, unless doing so would result in an undue hardship. Applicants for employment may request a reasonable accommodation/modification by contacting his/her recruiter.

We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

DISCLAIMER:

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities of this job to other entities; including but limited to subsidiaries, partners, or purchasers of Alight business units.

Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer.

Job Type: Full-time