Uncubed
           

Bilingual Member and Provider Services Representative

Bright Health, Lee's Summit, MO

WE’RE NEW, BUT WE’RE NOT NEW AT THIS.


ABOUT THE ROLE

The Member and Provider Services Representative role is to work directly with members and providers to establish rapport/connection and build confidence in Bright Health.  This will include members who come to the Bright office as well as callers (members and providers) who are referred by our business partners. As a Member and Provider Services Representative, they identify and rectify any complicated member or provider issues relating to Bright Health’s insurance benefits, claim processes, or enrollment and premium billing processes for all lines of business.

YOUR RESPONSIBILITIES

  • Partner with Bright members and providers to research and resolve escalated and complex member or provider issues, by phone, over chat, or in person.
  • Assist in researching, resolving and responding to social media escalations.
  • Collaborate across the organization to resolve complicated issues including, Claims, Enrollment, Billing, Provider Relations, Utilization Management, Sales, Broker Services, and all vendors.
  • Retain “at risk” members
  • Complete outbound call campaigns to welcome members, check in with members, build connection, and address special risk issues (Out of Network utilization, wellness opportunities), etc.
  • Properly recognize and triage complaints, grievances and appeals in a timely manner
  • Develop additional processes to further connect with the Bright Health members and providers.
  • Participate in the development and maintenance of policies and procedures relative to Customer Experience.
  • Assist in training of front-line Member and Provider Service Staff.
  • Complete various outbound call campaigns such as Welcome Calls, Check-In Calls, Special outbound call projects for high-risk members or providers.
  • Serve as a listening post to understand the voice of the Bright Health Customer and contribute ideas to improve the experience.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School diploma or GED required, Bachelor’s Degree preferred
  • Three (3) or more years of health insurance payer experience
  • Three (3) or more years of direct customer service support

PROFESSIONAL COMPETENCIES

  • Must have strong communication skills (verbal and written)
  • Must be highly organized and be able to prioritize work to meet deadlines
  • Must be successful working in an environment of ambiguity and change
  • Display strong strategic behaviors such as initiative, problem solving, critical thinking, judgment, innovation and independence
  • Ability to influence and collaborate with business partners throughout the organization.
ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 

We've won some fun awards like: Great Places to WorkModern HealthcareForbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

About Bright Health

Here’s the great thing about building a health plan from the ground up. We get to ask "why" at every turn – and make every decision a thoughtful one. But we’re different than other new health insurance companies because we come from big places. Our leaders have decades of experience working in health insurance and are committed to improving the customer experience. They started Bright Health because they know what to do and, more importantly, what not to do when creating a system that will actually work in your favor. Bright Health believes healthcare can be done better. Our carefully selected network: When we sat down to design Bright Health plans, we were thinking about relationships – the one between you and your doctor, and also the one between us and your doctor. Then we set out to create purposeful partnerships with caring providers. We call them our Care Partner. Our tight-knit network gives you access to a community of compassionate providers who are working together with us and with each other to help you live Brighter. Our commitment to service: When you need care, you want someone familiar who can help you, someone who actually feels good to interact with. And in-between visits to the doctor, you want someone who will help you thrive. So with any Bright Health plan, you get us, your Bright Health Team. We’re here, ready to help. No matter if your question is “Can I see this doctor?” or “How much is covered?” it’s easy to reach a real person who can get you the right answers and help you find the right care. There, that’s better. Our Whole Health Rewards: Keeping good health extends far beyond how many steps you take, what your BMI is, or what kind of food you eat. Don’t get us wrong, those things certainly contribute to your well-being but there’s a whole lot more to the picture. We provide opportunities for you to earn $$ throughout the year for making good decisions that lead to a Brighter life. When you and your health plan both want what’s best for you – it makes staying well a whole lot easier.

Want to learn more about Bright Health? Visit Bright Health's website.