Member Experience Specialist

Highmark Health • Washington, DC

7d • $22 - $33

About The Position

This job provides personalized support and guidance to customers through an omni-channel experience, leveraging knowledge of healthcare administration and integrated partnerships to proactively resolve inquiries, ensuring a positive and seamless experience and ultimately driving positive member behavior and cost-effective business outcomes.

Requirements

• 3 years of experience in customer service, healthcare administration, or related field
• Experience working with Highmark health plans and customer service systems
• Ability to apply in-depth product knowledge of health plan offerings
• Proficiency in using and navigating customer service systems specific to Highmark health plans
• Strong communication and interpersonal skills, with a focus on empathy and active listening
• Ability to work independently and as part of a team
• Proficiency in Microsoft Office Suite and other relevant software applications
• Ability to maintain confidentiality and adhere to HIPAA regulations

Nice To Haves

• Associate's degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree.

Responsibilities

• Serve as the primary point of contact for customers seeking information and assistance regarding their health benefits, claims, and online healthcare tools.
• Resolves standard and frequently non-routine, customer inquiries, comments, and concerns with the most limited escalation consistent with company policies and processes.
• Engage and guide members through clinical model complexities; connect members with appropriate clinical and non-clinical resources and redirect member site of care as defined by model and client requirements.
• Educate members on how to optimize insurance benefits by explaining the financial impact of healthcare choices, available provider/service options, and the importance of receiving the right care at the right time and place.
• Enroll members in programs that utilize digital tools designed to enhance their healthcare journey.
• Provide training and support to help members navigate these tools and actively engage in their own health management.
• Other duties as assigned or requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed