Claim Specialist

l rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work.

Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight.

Learn more at careers.alight.com

About the Role

The Health Navigation Claims Specialist position exists to work on behalf of our customers to resolve billing inquiries and discrepancies. Responsible for using acquired knowledge to deliver high-quality customer interactions that are consultative, lead to better outcomes, and drive increased benefit satisfaction.

Responsibilities

• Coordinating with external parties to resolve post-service coverage questions in an accurate and timely manner

• Partnering with internal parties to bring client awareness to unique care/billing situations that require special review

• Assisting in reviewing medical, dental, vision, and pharmacy related claims for accuracy to ensure customers are receiving proper benefit coverage

• Solving billing discrepancies, coding errors, and denied claims

• Assisting with claim submission and/or resubmission as needed

• Drafting, submit, and exhaust appeals processes, as necessary

• Coordinating with providers to verify payment plan and discount options

• Communicating directly with customers to explain ongoing status updates and educate them on processing details

• Offering process improvement ideas to enhance customer experience and delivery efficiency

Requirements

• Possess a Bachelor , Associate's with 2 years' billing/insurance experience, or 3 years' experience in billing/insurance or healthcare provider related role

• Able to work effectively in a team environment

• Possess excellent oral, written, and interpersonal communication skills

• Able and desire to learn continually in a changing environment

• Possess exceptional analytical, problem-solving, and organizational skills

• Able and passion to provide a high level of client satisfaction

• Able to receive and apply constructive feedback

Flexible Working

So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and "Top 100 Company for Remote Jobs" 5 years in a row.

Benefits

We offer programs and plans for a healthy mind, body, wallet and life because it's important our benefits care for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training as well as a number of voluntary benefit options.

By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

Our commitment to Inclusion

We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.

At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.

As part of this commitment, Alight will ensure that people with disabilities are provided with reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact [email protected].

Equal Opportunity Policy Statement

Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans and other covered veterans.

Alight provides reasonable accommodation to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodation/modification by contacting their recruiter.

Authorization to work in the Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the Employing Country and with Alight.

Note, this job description does not restrict 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.

We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

Salary Pay Range

Minimum :
45,000.00 USD
Maximum :
66,000.00 USD

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: Wellbeing and Benefits Selector Page - Alight

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.

Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer.