Health Pro - US Virtual
External
Alight · TX Texas VirtualFull-timeRemoteToday
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Benefits
Flexible WorkingSo that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and "Top 100 Company for Remote Jobs" 6 years in a row.Great Place to WorkThanks to the work of every colleague, 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." To learn more about our company culture and awards Click Here.If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight - We invite you to join our team! Learn more at careers.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.Activities include, but are not limited to the following:Gathering information about the reason the customer is seeking support or careEducating members on benefit programs provided by clientsTranslating complex benefit details (e.g., deductibles, coverage limits, prior authorizations) into clear, actionable guidance members can understand and useDelivering provider recommendations, referral guidance, and connections to clinical or employer‑sponsored programs to support informed care decisionsCompleting cost estimates and communicating out‑of‑pocket responsibility, claim results, denials, appeals, and escalation outcomes with accurate expectations and timelinesExplaining prescription formulary options, prescription alternatives, prior authorization outcomes, and available cost‑saving opportunitiesProactively identifying unmet clinical needs and owning the connection to appropriate clinical support and care resourcesConnecting members to company sponsored health and benefits programs for specialized careProviding proactive, timely updates via phone and digital channels and ensuring members feel supported through full case resolutionNavigating medical bill review results, including identified errors and savings achieved, and translating findings into clear, actionable guidance for membersDrafting carrier and client appeals for healthcare servicesCoordinating records transfers and authorization requests that require pre-service approvalRequired Qualifications2 years billing/insurance experience, or 3 years' experience in a billing/insurance/benefits related roleAbility to work effectively in a remote team environmentStrong problem solving, critical thinking, and analytical skills - ability to comprehend a member's needs and determine the steps required to complete their requestExceptional written communication skills - can convey complex coHealth insuranceDental insuranceVision insuranceRemote work optionsFlexible scheduleParental leave
Additional Information
Our Story 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 connecting purpose with impact. 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.
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