Analyst - Operations (Health Nav)
Job Description
Our story
At 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."
Our Values:
Champion People - be empathetic and help create a place where everyone belongs.
Grow with purpose - Be inspired by our higher calling of improving lives.
Be Alight - act with integrity, be real and empower others.
It's why we're so driven to connect passion with purpose. Our team's expertise in human insights and cloud technology gives companies and employees around the world the ability to power confident decisions, for life.
With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work.
Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight.
Learn more at careers.alight.com.
Role Description
Analyst Health Nav is an expert resource within the team responsible for ensuring we deliver timely and accurate information for all assigned tasks. Team Member should possess good learning agility, comm skills and shows flexibility as per the business needs. Contribute to build out our operational excellence capabilities to drive process improvements and process documentation also involves in- Knowledge Transfer & Process Set-Up. A critical part of your role as a Health Pro Specialist I will be to work as a patient advocate, a market researcher, and to provide administrative support for Health Pro Specialist IIs and Consultants. The job functions of this role will result in better health care experiences through reduced costs, specialized knowledge of the healthcare system, pricing transparency and higher quality medical care to improve overall satisfaction for individual health care consumers.
Responsibilities :
Work with health plan partners and providers to ensure accurate and timely Appointment Scheduling while ensuring that required IN Network and Out Of Network coverage is checked thoroughly and documented for the members ease of Appointment and Billing. All necessary documentation to begin research are received and notated on the customer's account. Resolve customer needs or concerns related to: Scheduling Appointment and Billing and Transferring medical records. Coordinating the approval of medication changes and transfer to the pharmacy.
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Full accountability for research and resolution of the customer's requirement including connecting them to additional benefits, resources, or programs. Save and log all customer documents in their file for record-keeping. Document all research and summarize calls in the case management system. Participate in ongoing training. Maintain Understanding of trained topics and processes. You may be asked to assist with additional tasks as needed.
- Fax, email, and mail documents to insurance companies and provider's offices to assist with scheduling appointment and coordinating services.
- Making outbound calls to offices to confirm and Schedule Appointments for Health Check-up's, Tests, Procedures.
- Scheduling member appointments based on outlined needs.
- Coordinating medical record transfers and prescription change requests.
- Merge, separate, and organize files to maintain member profile and assist with requests.
- Manage workload of 25-30 tasks per day.
- Maintain and consolidates documentation of SOPs/Operating Instructions
- Making Outbound calls to close tasks assigned.
- Participation in training sessions, presentations and meetings
- Ensure service accuracy through compliance, PG and SLA's.
- Ability to navigate, research, and utilize processing guidelines
- Executes Issue/Query/ Workflow Resolution and ensures proper documentation and follow-up takes place.
- Actively identify, learn, share, apply and disseminate process knowledge, best practices and process improvements.
- Occasional extended work hours/weekends to meet deadlines
- Should be cross trained can support Peak (Cross client & group contributions)
Eligibility Criteria
- Bachelor's degree in B.Com, B.A, BBA (No Full time MBA/MCA/B Tech/BE/B Ed)
- 4+ years of work experience
- Excellent verbal and written communication skills.
- Ability to understand client administrative environment, workflow management.
- Proficient with Office tools.
- Can work evening/night shifts as per business requirement
Benefits
We offer programs and plans for a healthy mind, body, wallet and life because it's important our benefits care for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training as well as a number of voluntary benefit options.
By applying for a position with Alight, you understand that, should you be made an 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.
Our commitment to Diversity and Inclusion
Alight is committed to diversity, equity, and inclusion. We celebrate 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 embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.
Diversity Policy Statement
Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state or local law. In addition, we take affirmative action to employ and advance in the employment of qualified minorities, women, disabled persons, disabled veterans and other covered veterans.
Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request a reasonable accommodation/modification by contacting his/her recruiter.
Authorization to work in the Employing Country
Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the Employing Country and with Alight.
Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.
DISCLAIMER:
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.
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Perks and Benefits
Health and Wellness
Parental Benefits
Work Flexibility
Office Life and Perks
Vacation and Time Off
Financial and Retirement
Professional Development
Diversity and Inclusion