SCOPE OF ROLE

The Team Lead, Member Services is responsible for providing exceptional & dedicated support to the MES Team, while demonstrating & incorporating the Bright values into day to day operations. 

ROLE RESPONSIBILITIES

• Collaborates or assists with internal and external Bright Health Partners to resolve Enrollment, Eligibility, Billing, and Underwriting issues.
• Provides support to MES team in the areas of collecting outstanding premiums, working with State-based exchange or Federal Facilitated Marketplace (FFM) to resolve enrollment, grace-period, premium, billing, APTC/CSR disputes or discrepancies.
• Assist or support MES team to review all incoming enrollment quarantine items to determine whether the enrollment may be accepted, requires additional information or should be rejected.
• Participates as needed in the discovery and resolution of root cause for recurring issues.
• Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.
• Communicate directly with members to discuss impact due to retroactive changes received from state-based exchange.
• Monitor calls and QA mentor, make decisions and deliver Performance Improvement Plan Action (or similar), approve/deny PTO, maintain 24 TAT for all tasks, train on systems, perform DLP maintenance, lead weekly team meetings and monthly 1:1s.
• Analyze and report daily/weekly/monthly metrics.
• Other duties and responsibilities as assigned.

SUPERVISORY RESPONSIBILITIES

• This position has supervisory responsibilities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• High School diploma or GED required.
• Three (3) years of IFP and/or FFM Health Insurance Industry required.
• Three (3) to five (5) years of customer service experience required.
• Claims or 834 EDI File experience preferred, but not required.
• Two (2)+ years of leadership experience required.
• Call monitoring and QA mentoring experience preferred but not required.
• Experience with Performance Improvement Plans or similar required.
• Experience with classroom and/or individual training sessions required.

PROFESSIONAL COMPETENCIES

• Strong communication skills, both verbal and written
• Organized and be able to prioritize work to meet deadlines
• Works independently with little supervision
• Able to thrive in an often-chaotic environment
• Understands regulatory and compliance rules surrounding enrollment and eligibility
• Results and detail oriented and understands the big picture
• Able to work independently with little supervision
• Able to thrive in an often-chaotic environment
• Able to understand regulatory and compliance rules surrounding enrollment and eligibility
• Results and detail oriented
• To be positive and accountable
• Team Unity

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: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing 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!