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Claims and Benefits Specialist

Accolade

Claims and Benefits Specialist

Plymouth Meeting, PA
Full Time
Paid
  • Responsibilities

    Job Description

    PLEASE COMPLETE AN APPLICATION BY CLICKING ON THE FOLLOWING LINK: HTTPS://OSV-ACCOLADE.WD5.MYWORKDAYJOBS.COM/EN-US/EXTERNAL_CAREERS/JOB/REQ202206-026-HEALTH-ASSISTANT--MEMBER-SERVICE-REPRESENTATIVE--AUGUST-2022---PA-_REQ202207-031

     

     

    As an Accolade Health Assistant, reporting to a Steward, you will be a trusted go-to resource who helps our

    clients with any issues related to their health or health benefits. You’ll have the opportunity to help clients get the right care at the right time… no problem is too big or too small.

     

    A DAY IN THE LIFE…

     

    Engage with clients and understand their needs

    • Answer inbound calls in a call center environment
    • Optimize & leverage the communication channels that fit for each client
    • Understand a client’s context
    • Uncover information about who our clients are & tailor our approach to fit their needs
    • Take a holistic approach to a client interaction
    • Understand what a client is really asking & resolve their questions fully
    • Close knowledge gaps
    • Actively listen for contextual red flags and uncover barriers
    • Use technology & data to gain a better understanding of needs the client may not be voicing
    • Uncover medical issues;
      • Actively listen for health red flags
      • Probe to uncover medical issues

     

    Deliver interventions

    • Support clients to navigate the complex and confusing health care system
    • Influence clients’ decisions & behavior by:
      • Making clients smarter consumers of health care
      • Being a translator of their benefit packages & care plans
      • Translating their benefit package in a way that they can take appropriate action
      • Being an aggregator to their entire ecosphere (vendors, carriers, providers, etc.)
      • Helping clients find doctors, in the way that best suits them
      • Uncovering barriers
    • Identify when & make it easy to connect with the right clinical resource (ex. Clinician, Health Plan Disease Management, Health Plan Case Management)
    • Leverage technology & internal resources (ex. Specialists, CSAs) to help understand the client’s path, actions needed & next step

     

    Drive better client outcomes

    • Assist with improved financial outcomes

      • Help clients avoid inappropriate health care usage & process errors
      • Help clients see the right providers at the right time
      • Help clients optimize benefit packages & third party vendors appropriately
    • Assist with improved health (medical & behavioral) outcomes

    • Help clients understand & optimize their preventive services

    • Help clients see the right providers at the right time (continuity of care)

    • Help clients have better managed chronic conditions

    • Assist with Rx compliance

    • Assist with treatment compliance

    • Help clients comply with regular doctor visits

    • Help clients monitor controlled health measures (controlled chronic, A1C levels)

    • Help clients reduce and/or eliminate avoidable admits, ER usage & readmits

    • Help clients have healthy babies

    • Help clients have an improved quality of life

     

    Delight clients

    • Create a personalized & memorable experience with Accolade
    • Meet clients where they are
    • Tailor our approach based on the client
    • Match tone, style & knowledge level
    • You are a client’s person when they need a person
    • Help clients help themselves
    • Build relationships through listening, honesty & empathy
    • Create a stickiness in Accolade’s service & capabilities
    • You are reliable
    • You are there when they reach out to us
    • You keep your promises (ex. we follow-up when we said we will)

     

    PLEASE COMPLETE AN APPLICATION BY CLICKING ON THE FOLLOWING LINK: HTTPS://OSV-ACCOLADE.WD5.MYWORKDAYJOBS.COM/EN-US/EXTERNAL_CAREERS/JOB/REQ202206-026-HEALTH-ASSISTANT--MEMBER-SERVICE-REPRESENTATIVE--AUGUST-2022---PA-_REQ202207-031

    WHAT WE ARE LOOKING FOR…

    REQUIRED:

    • High School Diploma/GED
    • 3+ years of experience in customer service industry
    • 2+ years of experience with Microsoft Office (Word, SharePoint, PowerPoint)

    PREFERRED:

    • Ability to thrive in a performance based environment
    • Demonstrate high level of personal accountability
    • Ability to listen, talk and type all at once through multi-channel communications
    • Empathetic critical thinking
    • Thrive in a team environment, capable of collaborating with individuals throughout the organization
    • Commitment to quality and continuous improvement
      • Strong self-management
      • Excellent written and verbal communication skills
      • Ability to perform well under pressure, adapt to change, and meet deadlines in a fast-paced dynamic, evolving environment
      • Aptitude for critical thinking / problem solving a true change champion and adapt to change quickly
      • Demonstrated attention to detail, inquisitive, problem-solving in nature
      • Ability to independently manage one’s own workload to meet the demands of the business
      • Operate from a perspective of truly caring about our clients and creating value for them

     

    Company Description

    Who are we? We’re a team that wants to make a difference in the world. This can be felt in the relationships we build with our members and in the innovations we bring to healthcare. You won’t find egos or office walls here. Just people who believe in doing the right thing, making an impact, and having fun. Our culture is something we built together, and it’s present in everything we do. We believe in fast-paced learning and think that the best development opportunities transcend job titles. Cross-collaboration is important to us, so our offices feature open facilities that make it easy. Feel like wearing jeans and sneakers? How about a suit? We support the attire that helps you feel comfortable.

  • Industry
    Financial Services