Imagine360 · 3 days ago
Member Benefit Specialist
United States
Full-time
Remote
Entry Level
$21/hr - $23/hr
1+ years expImagine360 is a health plan solution company seeking a Member Benefit Specialist to join their team. In this role, you will assist members with inquiries regarding benefit plans and provide support to enhance their healthcare experience.
Health CareHealth InsuranceInsurance
Responsibilities
Deliver above and beyond service over multiple channels including phone, email, portal inquiries, etc. by acting as a single point of contact, maintaining ownership of member resolution
Become an expert in benefit administration, Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs) and alternative benefit payment designs specifically reference based pricing
Guide understanding of health benefit coverage including accumulators, explanation of benefits, out of pocket maximums, and reimbursement levels
Take ownership of the member experience from beginning to end, reducing handoffs to others to ensure consistency and resolution
Anticipate the needs of members and conduct research on members' behalf to resolve issues
Educate members on pre and post services in conjunction with benefit to optimize the member experience throughout their healthcare journey
Collaborate with internal and external partners to ensure a best-in-class service delivery
Resolve member complaints
Treat all calls and correspondence using procedures and paying attention to the sections relating to HIPAA guidelines and the HIPAA Privacy Rules
Complete provider research, appointment scheduling, medical record retrieval and all other non-clinical duties assigned within applicable timeframes in compliance with PolicyProcedures
Accurate documentation in appropriate software, including CaseTrakker, Macess, etc
Qualification
Required
High school diploma or GED
1+ year healthcare industry work experience
Experience in delivering client-focused solutions based on customer needs within direct member contact and education
Ideally virtual/telephonic, in-person experience with the public
1+ year with telephonic verification of medical benefits
2+ years healthcare experience i.e. carrier, TPA, patient advocate, or other benefits focused role
Medical claims exposure (ICD-9/10 coding, CPT coding, and medical claim forms)
Proficient in Microsoft Outlook, Word and Excel
Service-driven mindset
Aptitude for learning and retention
Advanced soft skills with a high level of emotional intelligence
Strong written communication skills
Benefits
Multiple Health plan options
Company paid employee premiums for disability and life insurance
Parental Leave Policy
20 days PTO to start / 10 Paid Holidays
Tuition reimbursement
401k Company contribution
Company paid ShortLong term Disability plus Life Insurance
Professional development initiatives / continuous learning opportunities
Opportunities to participate in and support the company's diversity and inclusion initiatives
Company
Imagine360
Imagine360 is an integrated health plan addressing one of the greatest challenges on behalf of self-funded employers: healthcare costs are harming the bottom line, they're increasingly unaffordable for employees, and the experience remains poor.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Jeff Bak
President & CEO
Recent News
bloomberglaw.com
2025-08-26
2025-07-31
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