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Company | HealthCare Resolution Services, Inc. |
Address | Richmond, British Columbia, Canada |
Employment type | FULL_TIME |
Salary | |
Category | Health, Wellness & Fitness |
Expires | 2023-08-18 |
Posted at | 9 months ago |
Summary
Coordinates with the Client Management team to ensure Client needs are met, potential problems are averted, and to ensure we continue to provide solutions to the Client that exceed service expectations to access care. A key focus of this role is building trust with the Client (on site and/or virtually) to assist their employees and retiree population in getting optimal care at the right time and in the right setting; thereby reducing their costs and the costs to the plan. This position is required to be onsite multiple days per week in Maryland, Washington D.C., or Virginia.
Responsibilities
Coordinates with the Client Management team to ensure Client needs are met, potential problems are averted, and to ensure we continue to provide solutions to the Client that exceed service expectations to access care. A key focus of this role is building trust with the Client (on site and/or virtually) to assist their employees and retiree population in getting optimal care at the right time and in the right setting; thereby reducing their costs and the costs to the plan. This position is required to be onsite multiple days per week in Maryland, Washington D.C., or Virginia.
Responsibilities
- Deliver hands-on, dedicated, personalized support to the Client, their employees, retirees, and the Human Resources team.
- Interact with provider offices to respond to employee billing issues, access to services, etc.
- Respond to, own, and assist with escalated, complex issues and inquiries from the Client's benefits delivery team and/or the employees, including, but not limited to complex claim inquiries, service issues, provider authorizations, employee eligibility, billing, denials, appeals, incentive issues, and installation matters.
- Service customers across all medical platforms and products (as well as pharmacy, dental, and behavioral health, as needed) regarding their purchased product and services.
- Partner with internal Cigna matrix partners on global service issues impacting the Client and customer.
- Conduct on-site presentations for new hire, active, retiree, and/or prospective customers during open enrollment meeting and/or benefits fair to educate and inform of plan offerings.
- Excellent communication skills both verbally and in writing. Ability to work respectfully with people at all levels.
- Self-starter; able to work independently to get results.
- Health & Life license preferred, or ability to obtain Health & Life license within 90 days of employment.
- Preferred minimum two years' experience with multiple software and system-based applications, including database and spreadsheets (Word, Excel, and PowerPoint, tracking systems).
- Ability to be successful in a fast-paced and high-volume production environment.
- Proficient knowledge (min 3-5 years) in health care / benefits / managed care business; to include many or all of the following: product knowledge, underwriting, risk and financial analysis skills, marketing processes, sales practices, account management and knowledge of administrative operations.
- Bachelor's Degree preferred or equivalent work experience; minimum of 3 years' experience in account management, customer service, or health engagement, or claims related area preferred.
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