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Employer Service Rep - LHB

Role overview

Summary

This role focuses on resolving claim and customer service issues for external customers at Luminare Health. You will work closely with clients and internal teams to improve processes and ensure effective communication, contributing to the overall goal of simplifying and enhancing healthcare services.

Qualifications

  • High School diploma or GED equivalent.
  • Minimum five or more years claim processing/health insurance industry experience.
  • Excellent verbal and written communication skills.
  • Solid understanding of ERISA and DOL regulations.
  • Ability to effectively deal with problems in varying situations and reach resolution.

Responsibilities

  • Resolve claim and customer service issues initiated by clients or Client Management.
  • Research and track issues, providing recommendations for process improvements.
  • Communicate effectively with clients, Operations, and Client Management.
  • Summarize findings and develop recommendations based on research.

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • English

Hard skills

Other skills

  • Communication
  • Research
  • Problem Solving
  • Leadership
  • Organizational Skills
  • Social Skills
  • Critical Thinking
  • Adaptability

About the company

Health Care Service Corporation logo

Health Care Service Corporation

  • Health Insurance & Payers
  • XLarge
  • 10,001+
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.

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Job description

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.


We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.

Job Summary

This position is responsible for working with external customers to resolve claim and customer service issues initiated by clients or Client Management. Responsibilities include research and resolution of issues; recommendations for improvement of processes and procedures to eliminate recurrence of issues; communication with clients, Operations and Client Management; and tracking/monitoring of issues.

Required Job Qualifications:

  • High School diploma or GED equivalent
  • Minimum five or more years claim processing/health insurance industry experience
  • Ability to work in a fast-paced, customer service driven environment
  • Excellent verbal and written communication skills
  • Ability to research various topics, succinctly summarize findings and develop a recommendation
  • Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
  • Solid understanding of ERISA and DOL regulations
  • Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
  • Flexible; open to continued process improvement
  • Self-directed individual who works well with minimal supervision
  • Good leadership, organizational and interpersonal skills
  • Demonstrated critical thinking skills
  • Ability to effectively deal with problems in varying situations and reach resolution
  • Ability to learn new/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word

Preferred Job Qualifications:

  • Bachelor’s degree
  • Good presentation skills
  • Experience presenting and explaining benefits to a group or one-on-one

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

EEO Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Pay Transparency Statement:

At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. 

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:

$42,200.00 - $79,300.00

Exact compensation may vary based on skills, experience, and location.

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