Benefit Specialist

If you have a passion for helping individuals navigate and understand their employee benefits, we want to hear from you! HealthFitness is on the lookout for a talented Benefits Specialist to support our corporate client site in Spartanburg, South Carolina (SC).

Schedule: 40 hours/wk, M-F, Daytime, flexible. Typically 7:30a-4p or 8:30-5p

In this role, you will provide services to our Client’s employees and their families to assist in understanding, navigating, and getting the best value out of the healthcare, wellness and employee incentive programs provided by our Client. You will assist employees face-to-face and telephonically with navigating the healthcare system as they seek health and wellness services, interact with providers and insurers, find useful community resources and reduce the caller’s stress as well as saving time and costs.

Your impact:

• Understand all of the resources that are part of the Client benefits in order to be able to teach people how to use the available resources or to make appropriate referrals to other vendor programs and resources.
• Provide same Member experience regardless if communicating by phone, in person, email or online chat.
• Design and conduct new hire orientations, training on appropriate topics and present at Client meetings as requested.
• Manage benefits fairs and open enrollment activities.
• Participate/lead Client meetings, including Vendor Escalation Calls, Scorecard Review Meetings and All Hands Calls.
• Assist with development and training of Benefits Specialists (internally known as Care Champions).
• Primary contact and resource for all questions from other Care Champions. Work with Care Champions to ensure understanding and further develop them.
• Provide support for client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources. Assist and support Members in navigating the healthcare system as they seek health and wellness services and interact with providers and insurers.
• Determine if Member has followed the desired path and used existing tools to answer their questions or resolve the issue. If not, educate Member with the correct steps that should be followed by showing them how to use a tool or warm transfer to the appropriate resource. Client expects the Care Champion to use professional judgment to determine whether to perform the task for the Member or teach them how to perform the task.
• Assist with insurance claims and billing issues – investigate and help solve escalated issues.
• Provide guidance, advice, and support for health insurance appeals.
• Stay in contact with the Member through the resolution of their problem.
• Facilitate and coordinate delivery of healthcare related home and community based services.
• Identify and locate physicians, dentists, hospitals, wellness services, senior care and behavioral health services; assist with referrals and appointments.
• Maintain complete and accurate files and other applicable records.
• For members with specific needs, educate on specific health benefit solutions (i.e. hospice care, clinical trials, Centers of Medical Excellence, and senior/disabled caregiver services).
• Answer incoming calls, emails and secure instant messages from the Member and their covered family members.
• Respond to inbound advocacy calls, providing benefit navigation and education support.
• Carry out other duties as assigned.

What you bring with you:

• High school diploma or GED required.
• 1 to 3+ years of related healthcare/health insurance experience, claims processing, or provider billing.
• Demonstrated experience with managing (research, problem solving, organizing, tracking, reporting) client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources.
• Demonstrated Health Care Reform knowledge/experience and/or Medicare/Medicaid benefit knowledge.
• Demonstrated ability to work in a fast paced, constantly changing environment independently with minimal supervision.
• Ability to continuously display a positive attitude and follow directions.
• Ability to work independently, following established procedures defined by Client and HealthFitness.
• Proven ability to facilitate, lead and train individuals and or groups.
• Excellent written and verbal communication skills, including the ability to adapt communication style to persons representing diverse personal, professional, cultural, and socioeconomic backgrounds.
• Travel required (Approx. 1x/month to site in Fountain Inn and approx. 1x/year to site in NC).
• Work schedule will vary based on Client and territory needs.
• As part of the Client advocacy services, provide backup support as needed (during breaks or when call volumes are high).
• Other key characteristics include: excelled customer service skills, people-oriented, self-starter, well-organized and willing to truly learn Client’s benefits and culture in order to provide the functions listed above.
• Applicants must meet hiring requirements including but not limited to pre-employment drug test.

Visit our career page and apply today! https://www.healthfitness.com/join-our-team

HealthFitness, a Trustmark company, is a proven leader in providing fitness solutions that engage and connect people both on-site and online, to create a strong community of health. Our work focuses on creating meaningful connections with each of our participants to help them move forward. We foster each individual’s journey by creating communities of health within the organizations we serve – so that everyone is supported. We provide personal and professional support, training and development and flexible employment opportunities.

HealthFitness is committed to leveraging the talent of a diverse workforce to create great opportunities for our people and our business. EOE/AA. Race/Color/Gender/Sexual Orientation/Gender Identity/Religion/National Origin/Age/Disability/Veteran

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Ability to Relocate:

• Spartanburg, SC: Relocate before starting work (Required)

Work Location: In person