Member and Provider Services Representative at Bright Health

| Remote
Sorry, this job was removed at 11:23 a.m. (CST) on Thursday, July 22, 2021
Find out who's hiring in Austin.
See all Operations jobs in Austin
Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

The Member and Provider Services Representative role is to work directly with members and providers to establish rapport/connection and build confidence in Bright Health. This will include members who come to the Bright office as well as callers (members and providers) who are referred by our business partners. As a Member and Provider Services Representative, they identify and rectify any complicated member or provider issues relating to Bright Health’s insurance benefits, claim processes, or enrollment and premium billing processes for all lines of business.

ROLE RESPONSIBILITIES

  • Partner with Bright members and providers to research and resolve escalated and complex member or provider issues, by phone, over chat, or in person
  • Assist in researching, resolving and responding to social media escalations
  • Collaborate across the organization to resolve complicated issues including, Claims, Enrollment, Billing, Provider Relations, Utilization Management, Sales, Broker Services, and all vendors
  • Retain “at risk” members
  • Complete outbound call campaigns to welcome members, check in with members, build connection, and address special risk issues (Out of Network utilization, wellness opportunities), etc.
  • Properly recognize and triage complaints, grievances and appeals in a timely manner
  • Develop additional processes to further connect with the Bright Health members and providers
  • Participate in the development and maintenance of policies and procedures relative to Customer Experience
  • Assist in training of front-line Member and Provider Service Staff
  • Complete various outbound call campaigns such as Welcome Calls, Check-In Calls, Special outbound call projects for high-risk members or providers
  • Serve as a listening post to understand the voice of the Bright Health Customer and contribute ideas to improve the experience

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • High School diploma or GED required, Bachelor’s Degree preferred
  • Three (3) or more years of health insurance payer experience
  • Three (3) or more years of direct customer service support

PROFESSIONAL COMPETENCIES

  • Must have strong communication skills (verbal and written)
  • Must be highly organized and be able to prioritize work to meet deadlines
  • Must be successful working in an environment of ambiguity and change
  • Display strong strategic behaviors such as initiative, problem solving, critical thinking, judgment, innovation and independence
  • Ability to influence and collaborate with business partners throughout the organization

ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology, and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized, and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities, we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 

We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!

Read Full Job Description
Apply now
By clicking continue you agree to Built In’s Privacy Policy and Terms of Use.

Technology we use

  • Engineering
  • Product
  • Sales & Marketing
    • .NETLanguages
    • C#Languages
    • JavaLanguages
    • JavascriptLanguages
    • PythonLanguages
    • ScalaLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • ReduxLibraries
    • FlutterLibraries
    • ExpressFrameworks
    • Node.jsFrameworks
    • MongoDBDatabases
    • MySQLDatabases
    • PostgreSQLDatabases
    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • Aha!Management
    • ConfluenceManagement
    • JIRAManagement
    • Microsoft ProjectManagement
    • Microsoft DynamicsCRM

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.
Making Healthcare Better For All At Bright Health
Watch

An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 3% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Someone's primary function is managing the company’s diversity and inclusion initiatives
Mean gender pay gap below 10%
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

More Jobs at Bright Health73 open jobs
All Jobs
Data + Analytics
Design + UX
Dev + Engineer
Internships
Legal
Marketing
Operations
Product
Project Mgmt
Developer
new
Remote
Project Mgmt
new
Remote
Data + Analytics
new
Austin
Operations
new
Remote
Product
new
Remote
Developer
new
Remote
Data + Analytics
new
Remote
Data + Analytics
new
Remote
Operations
new
Remote
Operations
new
Remote
Operations
new
Austin
Project Mgmt
new
Austin
Data + Analytics
new
Austin
Operations
new
Remote
Marketing
new
Remote
Marketing
new
Remote
Developer
new
Remote
Product
new
Remote
Data + Analytics
new
Remote
Operations
new
Remote
Operations
new
Remote
Developer
new
Remote
Data + Analytics
new
Remote
Developer
new
Austin
Operations
new
Remote
Design + UX
new
Austin
Data + Analytics
new
Remote
Developer
new
Austin
Project Mgmt
new
Austin
Operations
new
Remote
Operations
new
Remote
Data + Analytics
new
Remote
Data + Analytics
new
Remote
Developer
new
Remote
Developer
new
Austin
Data + Analytics
new
Remote
Project Mgmt
new
Remote
Data + Analytics
new
Remote
Operations
new
Remote
Operations
new
Remote
Operations
new
Remote
Data + Analytics
new
Remote
Data + Analytics
new
Austin
Data + Analytics
new
Austin
Operations
new
Remote
Developer
new
Austin
Operations
new
Remote
Data + Analytics
new
Remote