Call Center- Member Benefit Specialist, 9:30am-6:30pm

Member Benefit Specialist, 10am-7pm Shift

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 maintain a professional demeanor and providing excellent customer service.

Key Duties & Responsibilities:

• Ability to read, understand, and communicate medical benefits according to SPD language;
• Respond to inquiries and phone calls from providers, policyholders, and agents regarding benefits, coverage, or claims status in accordance with established performance expectations;
• Maintain quality customer services through call center; follow customer service practices; adhere to timely expectations according to established expectations;
• Comfortable placing outbound calls for request and follow-up on additional information as needed for incomplete claims, to include but not limited to COB, accident investigations, eligibility, etc.;
• Familiar with and understands various fee schedules

Skills and Qualifications:

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

Better Benefits:

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
• Parental leave
• 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

More About Roundstone

Headquartered in Rocky River, Ohio, Roundstone is proud to be a Northeast Ohio Top Workplace as recognized by The Plain Dealer and cleveland.com, based on anonymous employee feedback. We foster a supportive, values-driven culture where employees feel engaged, valued, and celebrated. Roundstone has also been named an Inc. 5000 award recipient for eight consecutive years, reflecting our continued growth and success.

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 and in an effort to achieve a better match both from a candidate's perspective and our organization, please take a minute, click on the link and take the really brief survey:

https://go.apply.ci/p/OucR5fLyUj

Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Roundstone Insurance we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.