Company: Well-funded stealth company focused on disrupting healthcare through a differentiated consumer experience and a world-class data & analytics engine to drive engagement and behavior change. The product will sell directly to Fortune 500 CEOs and full risk populations, integrating layers of analytics, digital, concierge services, behavioral health, telemedicine, care management and wellness services to drive sustained engagement, lower costs and improve health.  A key differentiator to drive the company’s success will be a highly diverse, engaged organization whose employees are passionate about the mission of the company and whose management is passionate about the employees.

Reporting to: Sr. Manager, Support Services 

Start date: October 1st, 2019

Team: At Well, our members are at the core of everything we do. The role of our Member Services team is to create frictionless experiences for our members and to serve as an advocate for them.  Healthcare is complicated, and we are here to help our members navigate the system and implement lifestyle changes that lead to a healthy and productive life. Our offices may resemble a call center, but we are far from that! Everything from the mission to the technology to the type of talent we are looking to hire is different.  We seek to forge real relationships, while serving our members and their families with deep empathy.

Position Summary: We’re looking for a resourceful and knowledgeable team player with claims and benefits experience. The Claims Resource Specialist, will work in a customer-centric environment and will be able to administer and resolve all customer inquiries regarding claims and benefits. They will provide exceptional customer service both verbally and in writing. You will provide responses to all incoming and/or escalated inquires in a timely manner, and treat all people with respect and dignity -- while working with integrity in upholding our mission and values. This role is not a traditional claims and or billing follow up position, you will not be required to file or obtain payment on a claim. However, you will be assisting our members with questions regarding claims that has not been paid and/or denied, as well as answer any questions about their individual claim or bill. 

Location: Chapel Hill, NC

Key Responsibilities: 

  • Respond to inbound cases from Health Guides
  • Establish yourself as a claims subject matter expert inside the Member Services Organization
  • Be a utility player, and jump into inbound calls and chats when necessary
  • Administer proactive/reactive conversations with members about claims and benefits and document all members contacts
  • Be an essential partner in the feedback loop to the Member Services leadership team
  • Contribute to a friendly and inclusive work environment that’s aligned with Well’s core values
  • Communicate with Sr Manager, Support Services regarding needed workflows and training
  • Enhance the Member Experience by working with partners across the organization to continually improve the tools, systems and communication used by the team
  • Partner to build an effective, highly engaged specialty team that focus on quality and toughness
  • Respond to all escalations thoroughly, with ease and focus on our members experience
  • Provide exceptional customer service to our members
  • Utilize best practices to reinforce positive behavior

About You:

  • Bachelor's Degree or relevant combination of work experience and credentials required
  • 5+ years of work experience in claims and customer-centric environment required
  • Administer and resolve all customer inquiries regarding claims and benefits
  • Exceptional customer service and communication skills -- both verbally and in written form
  • Manage all communication with and Health Guides in both verbal and written forms
  • Provide responses to all incoming and/or escalated cases within the agreed upon SLA
  • Possess basic understanding and knowledge of health insurance benefits
  • Attention to detail, knowledge of ICD10, CPT, and HCPCS
  • Familiarity with healthcare and wellness trends and best practices
  • Exceptional problem-solving skills and ability to prioritize workload
  • Must treat all people with respect and dignity while working with integrity in upholding mission and values
  • Comfort working in a fast paced, always evolving, dynamic start-up environment, operating under a test-and-learn mindset while maintaining soundness of the operation
  • Possess the ability to de-escalate member situations regarding claims, while maintaining professionalism
  • Willing to roll up your sleeves and do what’s necessary
  • Able to see other points of view while maintaining confident direction
  • Entrepreneurial spirit, with the ability to convey a can-do, positive attitude towards tackling problems

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