[Hiring] Health Pro Consultant @Alight

Role Description

As a Health Pro, you can expect the following:

• Receive extensive health care and case management training to support members on complicated healthcare matters.
• Advocate for members requiring guidance across the health benefits environment.
• Help members navigate questions about their benefits, identify quality and cost-effective providers, and understand benefit claims.
• Gather a full understanding of the members’ needs and own the resolution of the customer’s request.

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 connections to clinical or employer-sponsored programs.
• Completing cost estimates and communicating claim results, denials, and appeals.
• 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 partnering with carriers and providers to resolve member needs.

You will interact with members through incoming calls, emails, and messaging system interactions, utilizing exceptional communication, empathy, and problem-solving skills.

Qualifications

• Minimum of 2 years of experience in a medical assistant/medical support role, or 3 years in a customer-facing role within the healthcare industry.
• Ability to work effectively in a remote team environment.
• Strong listening, reasoning, and analytical skills.
• Exceptional verbal and written communication skills.
• Strong ability and desire to learn continually in a changing environment.
• Exceptional critical thinking and problem-solving skills.
• 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.
• Ability to develop effective rapport with clients based on empathy and trust.
• Proficiency in MS Office suite.

Requirements

• Authorization to work in the Employing Country without requiring visa sponsorship.

Benefits

• A competitive total rewards package, starting on your first day of employment.
• Health, Dental, Vision, Life Insurance and more.
• A 401k plan that includes a corporate match.
• Paid Time Off: 10 paid holidays per calendar year (8 fixed and 2 floating) and 6 paid wellness days.
• Ongoing training, coaching, and development specific to the Health Pro role.

Company Description

At Alight, we believe a company’s success starts with its people. We champion people, help our colleagues grow with purpose, and encourage colleagues to “Be Alight.”

Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.

Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.”