Health Pro Specialist Health Pro Specialist with verification
About Alight Solutions
Alight is a leading cloud-based human capital technology and services provider that powers confident health, wealth, and wellbeing decisions for 36 million people and dependents over 25 years. The Alight Work life® platform combines data and analytics with a simple, seamless user experience. Supported by our global delivery capabilities, Alight Work life is transforming the employee experience for people around the world. With personalized, data-driven health, wealth, pay and wellbeing insights, Alight has more than 16,000 colleagues spanning the globe, proudly serving 4,300 clients and their more than 36 million employees and dependents.
HRO Processing Assistant III & Outsourcing Delivery Specialist
Role Description
In your role as a HRO Processing Assistant III/ Outsourcing Delivery Specialist; you will be working as a patient advocate, a market researcher, and to provide administrative support for Health Pro Specialist and Consultants. The job functions of this role will result in better health care experiences through reduced costs, specialized knowledge of the healthcare system, pricing transparency and higher quality medical care to improve overall satisfaction for individual health care consumers.
Key Responsibilities
Working effectively with Health Plan Partners and Providers
Ensuring proper documentation and research notes in customer account
Resolve customer needs or concerns related to:
Submitting claims and appeal to the health plan and providers.
Scheduling appointments.
Transferring medical records.
Coordinating the approval of medication changes
Fax, email, and mail documents to insurance companies and provider’s offices to assist with claim processing and coordinating services.
Making outbound calls to offices to confirm documents are received and processed.
Ensure completion of aligned work timely and with accuracy.
Able to practice logical reasoning and critical thinking.
Able to comprehend and deliver.
Shows flexibility to adapt to the changing needs of the business.
Participation in training sessions, presentations, and meetings
Contribution to the smooth operations and in day-to-day duties
Alignment to process as per business requirement.
Eligibility Criteria
Bachelor’s degree in B.Com, B.A, BBA (No Full time MBA/MCA/B Tech/BE/B Ed)
Minimum 4 years of work experience with customer services/ blended profiles
Excellent verbal and written communication skills.
Problem solving and analytical skills.
Strong organizational and time management proficiencies.
Demonstrated ability to recognize the need to change priorities to meet the business needs.
Evening shift ( 6:30 PM – 3:30 AM IST) as per business requirement
Experience with desktop/Windows navigation and keyboarding skills
We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.
Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: https://bit.ly/Alight_Benefits
DISCLAIMER:
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
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