Onsite Member Services Representative

Welcome to a team of caring and passionate people who work each day to meet the needs of our members and clients. At Health Benefits (a subsidiary of Health Care Service Corporation), you will be part of an organization committed to offering custom services to self-funded health benefits plans that manage costs – without compromising benefits – by offering innovative solutions, flexibility, transparency and customer support. This is an exciting time to join our team and enhance our culture that emphasizes caring, diversity and inclusion, mutual respect, collaboration and service to our communities.

Summary: This position is responsible for working onsite at the client’s office/facility (1001 E Lookout Drive, Richardson, TX 75082) – up to 5 days a week for the entire workday. Minimal working hours will be spent in a work-from-home office or in a Health Benefits office. The associate meets face-to-face with members to resolve claim issues, assist with understanding of benefits, assist with Open Enrollment activities, and support the Human Resources team with the benefits offered to its employees. The position also meets face-to-face with the client’s Human Resources personnel as needed under the direction of the Client Manager. The associate must project a high level of professionalism as they are an onsite representation of Health Benefits to members and the client.

Responsibilities include research and resolution of issues; recommendations for improvement of processes and procedures to eliminate recurrence of issues; professional and clear communication with members, clients, Operations and Client Management; and tracking/monitoring of issues.

Key Accountabilities

• Complete special client requests or projects, as directed.
• Appropriately notify, refer, or escalate inquiries.
• Develop and maintain relationships with select members, clients, Client Management and Claims & Customer Service personnel.
• Research and resolve claim inquiries initiated by members, clients and/or brokers.
• Track issues and document resolution.
• Meet face-to-face with members regarding their benefit questions.
• Follow-up regularly on outstanding inquiries to ensure timely resolution and member/client satisfaction.
• Provide verbal (or written) status updates and explanations to members, clients, brokers or Client Manager regarding issues.
• Other duties as needed/assigned.
• Recommend process improvements, procedural changes, or other actions to eliminate trends/issues.

Qualifications Include

• Ability to travel to the client(s) office/facility on a regular basis.
• Good presentation skills
• Ability to work in a fast-paced, client centric environment
• Self-directed individual who works well with minimal supervision
• Ability to work effectively with employees/members, providers, clients and various levels of staff
• Prior claim processing/health insurance experience
• Good leadership, organizational and interpersonal skills
• High School diploma or GED equivalent.
• Ability to effectively handle varying situations and reach resolution
• Ability to research and summarize findings and develop solutions or recommendations for resolution
• Excellent verbal and written communication skills
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
• Ability to adapt to various system platforms, and to effectively use MS Excel/Word
• Flexible; open to continued process improvements
• Demonstrated critical thinking skills

At Health Benefits, you will be part of an organization committed to offering meaningful benefits to our associates to support their life outside of work. From health and wellness benefits, 401(k) savings plan, a minimum of 15 days of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, new parent paid leave, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time associates.

The compensation range for this position is between $40,392.00 and $75,845.00. The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, sexual identity, age, veteran or disability.

Required Skills

Required Experience