Posted 1w ago

Customer & Client Resolution Specialist

@ GuideWell
San Antonio, Texas, United States
OnsiteFull Time
Responsibilities:Providing support, Utilizing systems, Resolving issues
Requirements Summary:1+ year in customer service; high school diploma or GED; healthcare knowledge (CPT/ICD-10, COBRA, HIPAA, benefits); strong written/oral communication; proficiency with MS Office; good judgment and analytical skills.
Technical Tools Mentioned:Microsoft Office
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Job Description

Get To Know Us!

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.

 

What is your impact?
The Client Resolution Specialist maintains responsibilities similar to a Customer Service Representative and is responsible for handling inbound customer calls from both providers and members but is more highly focused on resolving client-related issues and providing expert-level resolution to complex cases. This may include partnering with Benefits departments in trying to solve complex issues.

 

Job Details:

-In office at 19100 Ridgewood Pkwy San Antonio, TX 78259 required

-Ability to work between the hours of 7:00am - 7:00pm CST Monday to Friday

 

What Will You Be Doing: 

  • Provide standard client support: 
    • Primary client contact for claims and customer service issues and question for assigned accounts. Main customer service contact to resolve issues and identify customer needs on a pro-active basis.
  • Utilize systems to tract all assigned clients questions or concerns.
    Assisting with customer service phone calls and queues as assigned.
  • Provide expert level of assistance to members who have complex or escalated issues that have not been successfully resolved by normal means
    • Identify members who have high claim volumes or excessive calls to customer service, which may be an indication that they need help understanding their plan or help with finding solutions
    • Work directly with the Benefit Consultant for the employer group, to resolve claim or customer service issues.
  • Other responsibilities include researching claim appeals, researching benefit questions, and locating network providers. 
  • Provide direction and training to client-dedicated Customer Service Team staff 
    • Provide instruction and training to Customer Service Team when directed by the employer group or the Customer Service Manager. 
  • Assisting with assigned special projects. 


Qualifications

  • 1+ years related work experience in customer service 
  • High school diploma or GED 
  • Knowledge in the healthcare industry including CPT and ICD-10 coding, COBRA, HIPAA, pre-existing conditions, and coordination of benefits
  • Concise written and oral communication skills required, including the ability to deal with conflict. 
  • Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers. 
  • Knowledge of all MS Office products. 
  • Must possess proven judgment, decision-making skills and the ability to analyze. 

     

What We Can Offer YOU!

To support your wellbeing, comprehensive benefits are offered. As a WebTPA employee, you will have access to:

  • Medical, dental, vision, life and global travel health insurance

  • Income protection benefits: life insurance, Short- and long-term disability programs

  • Flexible schedules after training + future WAH options! 

  • Leave programs to support personal circumstances.

  • Retirement Savings Plan includes employer contribution and employer match

  • Paid time off, volunteer time off, and 11 holidays

  • Additional voluntary benefits available and a comprehensive wellness program

  • Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ.

General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally. 
Physical/Environmental Activities
Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally 

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.