Health & Benefits Specialist

• solving inbound tasks and instant messages from our internal team and resolve complex cases regarding claim, benefit, and eligibility issues by using internal tools, health plan insurance systems, and coordinating with our health plan partners
• act as a trusted partner for complex claims and benefit questions and issue resolutions
• act as a liaison to our health plan partners and providers in solving complex claims and benefit issues
• collaborate with teammates, member services teams, health plans, and providers to deliver the best possible service experience for clients of the company
• handle claim disputes with partner health plans on behalf of the client
• ensure compliance with internal and external health plan partner business processes
• develop and maintain solid working relationships and processes with health plans and other payors
• support internal teams with eligibility, benefits, and claims questions and/or issue resolution, including understanding the root cause of the issue
• listen, assess, and comprehend the clients’ presenting issue(s) and use critical thinking, judgment, and problem solving to take appropriate action
• identify opportunities to improve how we resolve claims and benefit issues, including improvements to InView, our benefit content, and other tools and resources
• support of client expectations and health plan processing guidelines

• excellent knowledge of English language, strong communication skills both in written and verbal
• ability to work independently, organize, and prioritize own tasks effectively
• previous experience in roles where technology, multi-tasking and verbal/written communication is

used to drive their day-to-day responsibilities is an advantage

• general computer literacy

• 5 weeks of vacation + personal days off
• annual bonus
• 1 paid day off for your volunteerism per year
• Sodexo Gastro Pass Card with no contribution
• Flexi Pass Card per month or Multisport Card
• cell phone and a plan for unlimited personal use as well
• parental benefits
• virtual hospital service uLekare.cz
• Ginger Emotional Support app
• Carrott - support on family forming journey 
• fresh fruits and office breakfasts
• office events-workshops, tournaments, competitions, raffles, team buildings