Benefit Specialist

HealthFitness, a Trustmark company, is a proven leader in providing fitness solutions that engage and connect people both on-site and online, to create a strong community of health. Our work focuses on creating meaningful connections with each of our participants to help them move forward. We foster each individual's journey by creating communities of health within the organizations we serve - so that everyone is supported. As an employee of HealthFitness you will enjoy a variety of health and financial benefits and receive competitive pay. We provide personal and professional support, training and development and flexible employment opportunities.

If you have a passion for helping individuals navigate and understand their employee benefits, we want to hear from you! HealthFitness is on the lookout for a talented Benefit Specialist to support our corporate client site in Greenville, South Carolina (SC).

Schedule: 40 hours/wk, M-F, Daytime, flexible. Typically 7:30a-4p or 8:30-5p

In this role, you will provide services to our Client's employees and their families to assist in understanding, navigating, and getting the best value out of the healthcare, wellness and employee incentive programs provided by our Client. You will assist employees face-to-face and telephonically with navigating the healthcare system as they seek health and wellness services, interact with providers and insurers, find useful community resources and reduce the caller's stress as well as saving time and costs.

Your impact:

• Understand all of the resources that are part of the Client benefits in order to be able to teach people how to use the available resources or to make appropriate referrals to other vendor programs and resources.

• Provide same Member experience regardless if communicating by phone, in person, email or online chat.

• Design and conduct new hire orientations, training on appropriate topics and present at Client meetings as requested.

• Manage benefits fairs and open enrollment activities.

• Participate/lead Client meetings, including Vendor Escalation Calls, Scorecard Review Meetings and All Hands Calls.

• Assist with development and training of Benefits Specialists (internally known as Care Champions) .

• Primary contact and resource for all questions from other Care Champions.Work with Care Champions to ensure understanding and further develop them.

• Provide support for client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources. Assist and support Members in navigating the healthcare system as they seek health and wellness services and interact with providers and insurers.

• Determine if Member has followed the desired path and used existing tools to answer their questions or resolve the issue. If not, educate Member with the correct steps that should be followed by showing them how to use a tool or warm transfer to the appropriate resource. Client expects the Care Champion to use professional judgment to determine whether to perform the task for the Member or teach them how to perform the task.

• Assist with insurance claims and billing issues - investigate and help solve escalated issues.

• Provide guidance, advice, and support for health insurance appeals.

• Stay in contact with the Member through the resolution of their problem.

• Facilitate and coordinate delivery of healthcare related home and community based services.

• Identify and locate physicians, dentists, hospitals, wellness services, senior care and behavioral health services; assist with referrals and appointments.

• Maintain complete and accurate files and other applicable records.

• For members with specific needs, educate on specific health benefit solutions (i.e. hospice care, clinical trials, Centers of Medical Excellence, and senior/disabled caregiver services).

• Answer incoming calls, emails and secure instant messages from the Member and their covered family members.

• Respond to inbound advocacy calls, providing benefit navigation and education support.

• Carry out other duties as assigned.

What you bring with you:

• High school diploma or GED required.

• 1 to 3+ years of related healthcare/health insurance experience, claims processing, or provider billing.

• Demonstrated experience with managing (research, problem solving, organizing, tracking, reporting) client advocacy cases that require one or multiple interactions with the client, providers, insurers, and community resources.

• Demonstrated Health Care Reform knowledge/experience and/or Medicare/Medicaid benefit knowledge.

• Demonstrated ability to work in a fast paced, constantly changing environment independently with minimal supervision.

• Ability to continuously display a positive attitude and follow directions.

• Ability to work independently, following established procedures defined by Client and HealthFitness.

• Proven ability to facilitate, lead and train individuals and or groups.

• Excellent written and verbal communication skills, including the ability to adapt communication style to persons representing diverse personal, professional, cultural, and socioeconomic backgrounds.

• Work schedule will vary based on Client and territory needs.

• As part of the Client advocacy services, provide backup support as needed (during breaks or when call volumes are high).

• Other key characteristics include: excelled customer service skills, people-oriented, self-starter, well-organized and willing to truly learn Client's benefits and culture in order to provide the functions listed above.

• Applicants must meet hiring requirements including but not limited to pre-employment drug test.

Brand: HealthFitness

Come join HealthFitness! Join a team that will not only utilize your current skills but will enhance them as well. We offer a comprehensive benefit package that includes Medical/Dental/Vision plans including HSA, PPO and FSA options, retirement/401(k) with employer matching program, fitness and wellness programs incentivized with medical plan discounts, certification reimbursement program, tuition reimbursement, paid new parent leave, paid Holidays and PTO (starting at 3 weeks for full-time associates), volunteer paid time off and much more.

HealthFitness is committed to leveraging the talent of a diverse workforce to create great opportunities for our people and our business. EOE/AA. Race/Color/Gender/Sexual Orientation/Gender Identity/Religion/National Origin/Age/Disability/Veteran

For the fourth consecutive year we were selected as a Top Workplace by the Chicago Tribune . The award is based exclusively on Trustmark associate responses to an anonymous survey. The survey measured 15 key drivers of engaged cultures that are critical to the success of an organization.

We are looking for strategic thinkers, innovators, team players and leaders who align with our purpose of improving the health and wellbeing of those we serve.

We're a nationwide team of more than 2,400 professionals who believe in the power of health and fitness - and creating opportunities for others to believe as well. We are dedicated to improving the health and wellbeing of those we serve and consider ourselves lucky to inspire, motivate and engage over 1 million participants across our 135 clients, from corporations to health systems to colleges and universities.

We started in 1975 as Fitness Systems. Over the years we expanded our services and capabilities to offer injury prevention and treatment and wellness services, so that we can truly care for the whole person. Today, we are HealthFitness and we're backed by Trustmark, a benefits company that has supported employers and their teams for more than 100 years.