Client Resolution Specialist

Get To Know Us!

WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.

What is your impact?
As a Client Resolution Specialist, you would be responsible for handling inbound calls but more highly focused on resolving client-related issues and providing expert-level resolution to complex cases. In this position you will interact with Benefits departments in trying to solve complex issues.

Key position details:

• In office at 6535 SH-161 S, Irving Texas 75039
• Full time position
• Comprehensive Benefits
• Training Hours: Monday to Friday 8:00am to 4:30pm CST
• Work Hours: Monday to Friday 7:00am - 3:30pm CST
• Growth Opportunities!

What you will be doing:

• Provide standard client support:
  
  
  
  • Primary client contact for claims and customer service issues and question for assigned accounts. Main customer service contact to resolve issues and identify customer needs on a pro-active basis.
  • Utilize systems to tract all assigned clients questions or concerns.
    Assisting with customer service phone calls and queues as assigned.
  
  
• Provide expert level of assistance to members who have complex or escalated issues that have not been successfully resolved by normal means
  
  
  
  • Identify members who have high claim volumes or excessive calls to customer service, which may be an indication that they need help understanding their plan or help with finding solutions
  • Work directly with the Benefit Consultant for the employer group, to resolve claim or customer service issues.
  
  
• Other responsibilities include researching claim appeals, researching benefit questions, locating in-network providers.
• Provide direction and training to client-dedicated Customer Service Team staff (5%):
  
  
  
  • Provide instruction and training to Customer Service Team when directed by the employer group or the Customer Service Manager.
  
  
• Assisting with assigned special projects.

Qualifications

• 1+ years related work experience in customer service in the healthcare industry
• High school diploma or GED
• Knowledge of CPT and ICD-9 coding, COBRA, HIPAA, pre-existing conditions, and coordination of benefits.
• Concise written and oral communication skills required, including the ability to deal with conflict.
• Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers.
• Knowledge of all MS Office products.

What We Can Offer YOU!

To support your wellbeing, comprehensive benefits are offered. As a WebTPA employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, Short- and long-term disability programs
• Leave programs to support personal circumstances
• Retirement Savings Plan includes employer contribution and employer match
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available and a comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ.

General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.
Physical/Environmental Activities
Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.