Job Description
Resonance CX Partners' mission is to help experienced professionals find opportunities that truly align with their values. We are not a staffing firm or agency. Resonance CX does not hire for these positions—we identify and validate them from customer-focused organizations directly. Employer Industry: Healthcare Services Why Consider This Job Opportunity Comprehensive healthcare benefits from day one, including vision and dental coverage Opportunity for career advancement and growth within the organization Supportive and collaborative work environment Chance to make a positive impact on customer satisfaction and member experience Engaging workplace culture focused on kindness, excellence, learning, innovation, and safety What To Expect (Job Responsibilities) Resolve and reconcile enrollment reports and eligibility issues by following policies and guidelines Communicate with newly enrolled Health Plan members and employer groups Interpret and apply rules and regulations in contractual agreements with employer groups and vendors Perform membership data extract reports for audit and compliance purposes Provide daily support to member and provider services staff regarding claims issues What Is Required (Qualifications) High School Diploma or Equivalent (GED) required Minimum of 1 year of customer service experience required Strong communication skills essential for customer retention and service Ability to interpret and apply policies and procedures effectively Proficiency in using online software for membership data and workflow management How To Stand Out (Preferred Qualifications) Experience in the healthcare industry or working with health plans Familiarity with claims processing and eligibility determination Knowledge of state legislated coverage and eligibility guidelines Strong problem-solving skills and attention to detail Ability to work collaboratively in a team-oriented environment #HealthcareServices #CustomerService #CareerOpportunity #HealthcareBenefits #DiversityAndInclusion We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer. #ResonanceCXPartners