Alight Solutions hiring Health Client Specialist – Claims and Appeals Management in Illinois, United States | LinkedIn (2024)

Amazing Opportunity and Great Place to Work! Are you a fast learner who is fascinated by Client interactions? 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.

About The RoleThe Client Specialist manages claims, appeals, and ERISA deadlines. They also handle urgent client escalations and engage in quality assurance reviews. Additionally, they support teammates with workload management and interact with customer care or delivery teams.

Responsibilities

• Collaborating with the client manager and end client to resolve requests or escalated employee issues.
• Conducting comprehensive research on employee accounts. This involves making initial claim determinations using available tools and resources and requires in-depth investigations to ensure fair outcomes for employees.
• Compiling level two appeal packets, including employee arguments, account status, calls, and web activity. Provide a comprehensive overview of events leading to the claim and appeal to the committee.
• Presenting claim and appeal findings to clients. You will also collaborate with internal colleagues, third-party providers, and client contacts.
• Utilizing tools to aggregate data to identify process improvement opportunities. Analyze trends so we can improve quality, the customer experience, and to reduce risk.
• Assisting the CM and our delivery partner in any client escalations. Oversees the resolution to ensure client satisfaction.
• Managing projects of small to medium size and complexity from beginning to end. Provide subject matter expertise to client.
• Co-leads, leads and participates in internal and external meetings.
• In this role, you will co-lead external client acceptance testing sessions and support key client contacts. Your main focus will be integrating plan requirements and business rules into system flows and participant-facing tools.
• As the primary responsibility, you will meticulously conduct acceptance testing to ensure system capabilities. Meet client requirements, crucial for maintaining system quality and functionality.

Requirements

• Able to adapt to changing requirements.
• Able to translate ideas & concepts into requirements that drive technical and process solutions.
• Possess analytic, problem-solving, and organizational skills.
• Able to learn quickly and apply feedback.
• Able to work with plan documents, participant accounts, and employee benefits concepts.
• Possess attention to detail.
• Possess written and verbal communication skills.
• Able to work independently with minimum supervision.
• Able to work under tight deadlines and managing multiple tasks.
• Possess Knowledge of multiple web-based tools including MS Office Excel/Word, CSPro, TBA system.

Flexible Working

So that you can be your 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” 5 years in a row.

BenefitsWe 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.

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We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

Salary Pay Range

Minimum :

35,600 USD

Maximum :

56,600 USD

Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: https://bit.ly/Alight_Benefits

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.

Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer.