[Hiring] Employer Service Rep @Luminare Health

Role Description

This position supports Tribal ESR operations and serves a highly visible Tribal customer group. Candidate must demonstrate the ability to provide a consistently high level of service, professionalism, and responsiveness to meet the service expectations and unique needs of Tribal business partners.

• Research and resolve claim issues initiated by clients and/or brokers.
• Provide timely written or verbal status updates and explanations to clients, brokers or Client Management regarding issues.
• Follow-up regularly on outstanding issues to ensure timely resolution and client satisfaction.
• Appropriately notify, refer or escalate issues.
• Track issues and document resolution. Provide issue reports to Claims & Customer Management and Client Management on a regular basis. May also provide periodic reports to clients.
• Recommend process, procedure or other actions to eliminate reoccurrence of issues or prevent future issues.
• Develop and maintain good relationships with select clients, Client Management and Claims & Customer Service personnel.
• Assist with benefit fairs or benefit meetings.
• Complete special client requests or projects, as directed.
• Other duties as needed/assigned.

Qualifications

• Tribal experience required.
• High School diploma or GED equivalent.
• Minimum five or more years claim processing/health insurance industry experience.
• Ability to work in a fast-paced, customer service driven environment.
• Excellent verbal and written communication skills.
• Ability to research various topics, succinctly summarize findings and develop a recommendation.
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff.
• Solid understanding of ERISA and DOL regulations.
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs).
• Flexible; open to continued process improvement.
• Self-directed individual who works well with minimal supervision.
• Good leadership, organizational and interpersonal skills.
• Demonstrated critical thinking skills.
• Ability to effectively deal with problems in varying situations and reach resolution.
• Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word.

Requirements

• Bachelor’s degree (preferred).
• Good presentation skills.
• Experience presenting and explaining benefits to a group or one-on-one.

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• Paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Other incentives.

Company Description

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range: $42,200.00 - $79,300.00. Exact compensation may vary based on skills, experience, and location.