Call Center- Member Benefits Specialist

Overview

Call Center
- Member Benefit Specialist — Founded in 2003, Roundstone is not your typical insurance company. We’re on a mission to help employers save on healthcare benefits so they can put those savings towards bettering their businesses and taking care of their employees.

Role

Description:

As a Member Benefit Specialist you will assist policy holders, providers and agents with their health insurance inquiries and concerns over the phone. Your duties will include answering questions about coverage, claims, benefits and resolving billing issues. This role requires the ability to maintain accurate records of customer interactions in a high volume call center while maintaining a professional demeanor and providing excellent customer service.

• Read, understand, and communicate medical benefits according to SPD language
• Respond to inquiries from providers, policyholders, and agents regarding benefits, coverage, or claims status in accordance with established performance expectations
• Maintain quality customer service through call center practices; adhere to timely expectations according to established standards
• Place outbound calls for requests and follow-up on additional information as needed for incomplete claims, including COB, accident investigations, eligibility, etc.
• Familiar with and understand various fee schedules

• Knowledge of TPA administrative services, policies, procedures and systems
• 6 months+ of customer service call center experience in a medical insurance environment addressing member and provider calls
• Dental and Vision benefit knowledge is a plus
• Excellent verbal, communication, and written skills with strong organizational and research abilities
• Proficiency in Microsoft Office (Word, Excel and Access)
• Detail-oriented, able to work under pressure, and able to handle multiple tasks with deadlines
• Bilingual (English/Spanish) skills a plus

We’re leaders in our industry, so naturally, we look out for our employees’ best interests with a robust benefits package. Roundstone employees are eligible for:

• Medical, dental and vision benefits
• Annual bonus
• Dependent care 100% match up to max allowable
• PTO beginning on Day 1
• Tuition reimbursement
• Health work/life balance
• Hybrid office schedule
• 401(k) plan with company match
• Employee Assistance Program
• On-site gym with personal trainer access
• Life insurance and short term disability insurance

Headquartered in Rocky River, Ohio, Roundstone is regularly recognized as a Northeast Ohio Top Workplace by the Plain Dealer and  We are proud to be recognized as a Top Workplace since this honor is determined by anonymous feedback from our own employees. Roundstone employees enjoy a supportive workplace where they are engaged, valued and regularly recognized for their hard work at monthly company meetings.

Roundstone’s core values are evident every day and are shared with the community through sponsorship of community events and outreach.

Our Core Values

• Live well:
  Be healthier and bring positive energy to all you do.
• Work smarter:
  Get things done, better.
• Own it:
  Accountability is your middle name. Be on time, do what you say, and finish what you start.
• Be intellectually curious:
  Always be learning. See opportunity everywhere and have a drive to know.

Culture and fit are integral to success. We encourage you to apply if you’re excited about the role even if your past experience doesn’t align perfectly with every qualification.