Client Resolution Specialist

Client Resolution Specialist The Client Resolution Specialist is an early career position that will serve as a key resource for members, providers, clients, and internal teams by resolving complex service‑related cases. This includes supporting Customer Service with both inbound and outbound calls and partnering with various departments for resolution. Job Details In office at 6535 North State Highway 161, Irving, TX 75039 Ability to work between the hours of 7:00am – 7:00pm CST, Monday to Friday Responsibilities Provide standard client support Primary client contact for claims and customer service issues for assigned accounts, identifying customer needs proactively. Track all assigned client questions and concerns. Assist with customer service phone calls and queues as assigned. Provide expert assistance to members with complex or escalated issues not resolved by normal means Identify members with high claim volumes or excessive calls, indicating need for plan understanding or solutions. Work directly with the Benefit Consultant for the employer group to resolve claim or customer service issues. Research claim appeals, benefit questions, and locate network providers Provide direction and training to client‑dedicated Customer Service Team staff. Provide instruction and training to Customer Service Team when directed by the employer group or the Customer Service Manager. Assist with assigned special projects. Qualifications 1+ years related work experience in customer service High school diploma or GED Knowledge of the healthcare industry including CPT and ICD‑10 coding, COBRA, HIPAA, pre‑existing conditions, and coordination of benefits Concise written and oral communication skills, including conflict resolution Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers Knowledge of all MS Office products Proven judgment, decision‑making skills, and the ability to analyze Benefits Medical, dental, vision, life and global travel health insurance Income protection benefits: life insurance, short‑ and long‑term disability programs Leave programs to support personal circumstances Retirement savings plan with employer contribution and match Paid time off, volunteer time off, and 11 holidays Additional voluntary benefits and comprehensive wellness program Physical & Environmental Demands Sedentary work with occasional exertion up to 10 pounds. Occasional travel to multiple locations for meetings, events, and conferences. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment. #J-18808-Ljbffr