OurStory
At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight."We are passionate about connectingpurposewith impact.Alightempowersclientsto builda healthierandmorefinancially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing,navigation, andabsence management.
Our Benefits
With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and visioncoveragesstartingDay One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization.
Flexible Working
So that you canbeyour best at work and home, we consider flexible working arrangements wherever possible. Alighthas been a leader in the flexible workspace and "Top 100 Company for Remote Jobs"6yearsin a row.
Great PlacetoWork
Thanks to the work of everycolleague, Alight has received multiple awards of recognition including"GreatPlace to Work" for the past 7 years and Fortune's "Best Companies to Work For." To learn more about our company culture and awardsClick Here.
If you,Champion People,seekto Grow with Purpose,and embody the meaning of Be Alight- We invite you to join our team!Learn more atcareers.alight.com.
Career Development & Growth:
We provide ongoing training, coaching and development specific to the Navigation Research role and reward continuous improvement, while encouraging you to own your own development.
As a Health Pro, you can expect the following:
When you start, you will receive extensive health care and case management training to ensure you are equipped to support members on complicated healthcare matters.
Your primary responsibility is to be an advocate for members requiring guidance across the health benefits environment by helping them navigate questions about their benefits, identify the highest quality and cost-effective providers, understand benefit claims, and be an advocate for the employee across the health ecosystem. You will gather a full understanding of the members' needs and own the resolution of the customer's request.
Activities include, but are not limited to the following:
Gathering information about the reason the customer is seeking support or care
Educating members on benefit programs provided by clients
Translating complex benefit details (e.g., deductibles, coverage limits, prior authorizations) into clear, actionable guidance members can understand and use
Delivering provider recommendations, referral guidance, and connections to clinical or employersponsored programs to support informed care decisions
Completing cost estimates and communicating outofpocket responsibility, claim results, denials, appeals, and escalation outcomes with accurate expectations and timelines
Explaining prescription formulary options, prescription alternatives, prior authorization outcomes, and available costsaving opportunities
Proactively identifying unmet clinical needs and owning the connection to appropriate clinical support and care resources
Connecting members to company sponsored health and benefits programs for specialized care
Providing proactive, timely updates via phone and digital channels and ensuring members feel supported through full case resolution
Navigating medical bill review results, including identified errors and savings achieved, and translating findings into clear, actionable guidance for members
Drafting carrier and client appeals for healthcare services
Coordinating records transfers and authorization requests that require pre-service approval
This work involves leveraging developed methodologies, navigating internal tools and applications, as well as making external phone calls, partnering with carriers and providers (via email and phone outreach) to resolve member needs. The scope of work is dedicated at the employee level and you will be responsible for working employee cases through resolution.
You will interact with members through incoming calls, emails, and messaging system interactions. You will be responsible for utilizing exceptional communication, empathy, and problem solving skills to understand and solve complex customer needs, resulting in a better experience for the employee's entire healthcare journey.
Required 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 - ability to comprehend a member's needs and determine the steps required to complete their request
Exceptional written communication skills - can convey complex concepts in writing for members that are not benefits experts
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
Preferred Qualifications
Previous healthcare setting... For full info follow application link.
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
