Member Solutions Coordinator

2 weeks ago

Birmingham, United States Tokio Marine HCC Full time
Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world. Organic growth and over 60 successful acquisitions have grown our 2022 Gross Written Premium (GWP) to $5 Billion. Our workforce has grown to 4,300 worldwide ... big, but not so big that you cannot make a difference. Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work.

TMHCC A&H , a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers. Medical Stop Loss provides an added layer of insurance protection to employers who choose to self-fund their health benefit plans. Self-funding can incur risks from catastrophic claims, and Medical Stop Loss insurance from Tokio Marine A&H is designed to protect employers from that risk.

*This role is located onsite in Birmingham, AL*

Position Summary:

Under supervision, this position is responsible for assisting customers and providers navigate insurance plans and coverage to facilitate the pathway to care.

Key Responsibilities:
  • Strong sense of urgency handling a high-volume amount of inbound and occasionally outbound calls.
  • Engage with customers and providers to verify insurance benefits and check claim status.
  • Strong working knowledge of insurance coverages and EOB's.
  • Verifies insurance and claim status in communicating regularly with doctors' offices and insurance holders.
  • Manages challenging customer service situations while maintaining a positive, empathetic, and consultative approach towards the customer during their time of need.
  • Maintains working knowledge of insurance co-pays and deductible to ensure accurate and compliant billing information.
  • Answers telephones, takes, and directs messages on a timely basis according to the direction and location appropriate to maintain continuous workflow.
  • Maintains an organized and efficient work environment by keeping files and records neat and orderly to promote a smooth workflow and to ensure confidentiality.
  • Must have excellent multitasking skills, with the ability to work on projects simultaneously.
  • Adheres to all HIPPA policies.
  • Provides assistance with call backs and other projects as call volume permits.

Education, Experience & Knowledge
  • Minimum High School or GED Up to
  • two years of relevant experience
  • Knowledge of quality measures and procedures
  • Ability to support and represent a team's needs to other departments
  • Possess and have ability to apply advanced knowledge of principles, practices, and procedures
  • Excellent written and verbal communications skills with an emphasis on confidentiality, tact, and diplomacy
  • Superior organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
  • Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business environment
  • Overtime hours may be required to fulfill job responsibilities
  • May be required to remain stationary for extended periods of time
  • May be required to move up to 10 pounds
  • Must be able to operate a computer and other devices
  • Close vision and ability to adjust focus, such as required to read a computer screen

Tokio Marine offers a competitive salary and benefits package, including:
  • Generous paid time off (PTO), 12 paid company holidays,
  • 401(k) Retirement Plan with 6% company match.
  • Health and dental insurance, and vision plan available.
  • Company-provided long-term disability and life insurance.
  • Opportunities for advancement in a successful and growing organization.
  • Flexible work schedules and a great work/life balance.
  • Paid Parental Leave.
  • Volunteer Time Off.
  • Enjoy casual dress and work in a modern, comfortable office with free parking.
  • Hybrid work schedule

The Tokio Marine HCC Group of Companies offers a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals. The Tokio Marine HCC Group of Companies is an equal-opportunity employer. Please visit www.tmhcc.com for more information about our companies.

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