[Hiring] Health Pro @Alight Solutions

Role Description

As a Health Pro, you can expect the following:

• Receive extensive health care and case management training.
• Advocate for members requiring guidance across the health benefits environment.
• Help members navigate questions about their benefits.
• Identify the highest quality and cost-effective providers.
• Understand benefit claims and advocate for employees across the health ecosystem.
• Gather a full understanding of members’ needs and own the resolution of customer requests.

Activities include, but are not limited to:

• Gathering information about the reason the customer is seeking support or care.
• Educating members on benefit programs provided by clients.
• Translating complex benefit details into clear, actionable guidance.
• Delivering provider recommendations and referral guidance.
• Completing cost estimates and communicating out-of-pocket responsibilities.
• Explaining prescription formulary options and available cost-saving opportunities.
• Proactively identifying unmet clinical needs and connecting to appropriate resources.
• Providing proactive, timely updates via phone and digital channels.
• Navigating medical bill review results and translating findings into actionable guidance.
• Drafting carrier and client appeals for healthcare services.
• Coordinating records transfers and authorization requests.

This work involves leveraging developed methodologies, navigating internal tools and applications, and making external phone calls to resolve member needs.

Qualifications

• 2 years billing/insurance experience, or 3 years’ experience in a billing/insurance/benefits related role.
• Ability to work effectively in a remote team environment.
• Strong problem solving, critical thinking, and analytical skills.
• Exceptional written communication skills.
• Strong ability and desire to learn continually in a changing environment.
• Ability to efficiently organize work activities to meet deadlines.
• Passion to provide the highest level of client satisfaction.
• Ability to receive and immediately apply constructive feedback.
• Proficiency in MS Office suite.

Requirements

• Previous healthcare setting experience (preferred).
• Previous benefits and/or HR experience (preferred).

Benefits

• Comprehensive total rewards package.
• Health, dental, and vision coverages starting Day One.
• Wellbeing programs.
• Retirement plans with contribution matching.
• Generous time off and parental leave.
• Continuing education and career growth opportunities.
• Flexible working arrangements.