Member Care Consultant

3 weeks ago

Bristol, Bristol, United Kingdom Healix Full time
Job Overview

We are excited to announce openings for 10 client support roles at our Healix Health office. If you are seeking a fulfilling career in the healthcare sector and possess exceptional customer service abilities, you may be an ideal candidate for our Member Care Consultant position.

As a Member Care Consultant, your primary responsibilities will include coordinating treatment plans for members, collaborating with the healthcare team, and ensuring that members receive accurate medical information and access to necessary services. This role emphasizes strong customer service skills, and no medical qualifications are required.

Candidate Profile

We are in search of individuals who exhibit the following qualifications:

  • Familiarity with the private medical insurance sector and claims processing is a plus.
  • Proactive in understanding client needs and capable of interpreting relevant policy documents.
  • High standard of customer service with a focus on client-centered thinking.
  • Strong decision-making abilities and the capacity to act independently.
  • Excellent verbal and written communication skills with a diplomatic approach.
  • Attention to detail and the ability to perform well under pressure.
  • Capability to work both independently and collaboratively within a team.
  • Strong problem-solving and analytical skills.
  • Commercial awareness with a focus on the broader context of decisions.
  • Ability to effectively communicate with clinicians and assess information accurately.
  • Awareness of technological advancements in the industry to anticipate potential inquiries.

Role Responsibilities

In this position, you will engage in:

  • Handling calls from clients and healthcare providers regarding claims.
  • Collecting medical evidence to support claims decisions.
  • Addressing inquiries related to clinical treatments or pre-authorization requests.
  • Coordinating care with the appropriate medical teams or facilities.
  • Monitoring ongoing treatment plans to ensure relevance and appropriateness.
  • Negotiating provider fees as part of cost management for clients.
  • Ensuring accurate documentation within the Case Management System.
  • Supporting Case Managers with high-cost claims as needed.

About Healix

We provide comprehensive healthcare benefits and assistance services globally. Our mission is to support individuals in challenging situations, whether it involves medical emergencies or crises. Our dedicated teams of healthcare professionals and coordinators ensure that clients receive the necessary assistance and care.

We collaborate with various organizations, adapting our services to meet unique client needs. Our approach prioritizes personal connections, allowing us to respond effectively to the diverse challenges faced by our clients.

Company Culture

At Healix, we emphasize a supportive and dynamic work environment that encourages initiative and innovation. Our employees are committed to excellence, and we offer opportunities for professional growth within a collaborative team atmosphere.

We strive to maintain a culture that attracts diverse talent and fosters a sense of belonging. As part of our team, you can expect a range of benefits and a workplace where individuals truly care about one another.

Essential Criteria

  • Previous experience in customer service is required.
  • Proficiency in the English language is essential.

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