Health Pro Consultant - US Virtual

Our storyAt 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 connectingpurposewith impact.Alightempowersclientsto builda healthierandmorefinancially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing,navigation, andabsence management.Our BenefitsWith a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and visioncoveragesstartingDay One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization.Flexible WorkingSo that you canbeyour 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"6yearsin a row.Great PlacetoWorkThanks to the work of everycolleague, Alight has received multiple awards of recognition including"GreatPlace to Work" for the past 7 years and Fortune's "Best Companies to Work For." To learn more about our company culture and awardsClick Here.If you,Champion People,seekto Grow with Purpose,and embody the meaning of Be Alight- We invite you to join our team!Learn more atcareers.alight.com.We Offer YouA competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization:A full Benefits Package, starting on your first day of employmentHealth, Dental, Vision, Life Insurance and more.A 401k plan that includes a corporate match.Paid Time Off10 paid holidays per calendar year (8 fixed and 2 floating)6 paid wellness daysCareer Development & GrowthWe provide ongoing training, coaching and development specific to the Health Pro role and reward continuous improvement while encouraging you to own your own development.Alight provides a collaborative environment that embodies and holds the following stated values close to heart: Champion People, Grow with Purpose, and Be Alight.As a Health Pro, You Can Expect The FollowingWhen you start, you will receive extensive health care and case management training to ensure you are equipped to support members on complicated healthcare mattersBenefitsYour primary responsibility is to be an advocate for members requiring guidance across the health benefits environment by helping them navigate questions about their benefits, identify the highest quality and cost-effective providers, understand benefit claims, and be an advocate for the employee across the health ecosystem. You will gather a full understanding of the members' needs and own the resolution of the customer's request. 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 employersponsored programs to support informed care decisionsCompleting cost estimates and communicating outofpocket responsibility, claim results, denials, appeals, and escalation outcomes with accurate ex ectations and timelinesExplaining prescription formulary options, prescription alternatives, prior authorization outcomes, and available costsaving 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 approvalThis work involves leveraging developed methodologies, navigating internal tools and applications, as well as making external phone calls, partnering with carriers and providers (via email and phone outreach) to resolve member needs. The scope of work is dedicated at the employee level and you will be responsible for working employee cases through resolution.You will interact with members through incoming calls, emails, and messaging system interactions. You will be responsible for utilizing exceptional communication, empathy, and problem solving skills to understand and solve complex customer needs, resulting in a better experience for the employee's entire healthcare journey.Required QualificationsMinimum of 2 years of experience in a medical assistant/medical support role, or 3 years of experience working in a customer-facing role within the healthcare industryAbility to work effectively in a remote team environmentStrong listening, reasoning, and analytical skills - ability to listen to members' needs and dig deeper to understand the root cause of their concern with empathy.Exceptional verbal and written communication skills - can convey complex concepts, both verbally and in writing, for members that are not benefits expertsStrong ability and desire to learn continually in a changing environmentExceptional critical thinking and problem-solving skillsAbility to efficiently organize work activities to meet deadlinesPassion to provide the highest level of client satisfactionAbility to receive and immediately apply constructive feedbackAbility to develop effective rapport with clients based on empathy and trustProficiency in MS Office suiteApplication and InterviewBy applying for a position with Alight, you understand that, should you bemadean offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.Alight requires all virtual interviews to be conducted on video.Our commitment to InclusionWecelebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.At Alight, we welcome and embr