Issue Resolution Specialist

Issue Resolution SpecialistIndependence is a Qualified Health Plan issuer participating in the Federally Facilitated Marketplace and State-Based Exchanges (SBE). We are responsible for resolving Exchange casework within strict regulatory timeframes that directly impact members' access to healthcare. As an Issue Resolution Specialist, you will play a critical frontline role in investigating and resolving complex cases. This is an opportunity to apply your analytical skills, problem-solving abilities, and attention to detail to make a meaningful impact on member experiences while navigating a dynamic and highly regulated environment.Key ResponsibilitiesManage and prioritize a daily caseload to ensure cases are resolved accurately, efficiently, and within required compliance timeframesInvestigate and analyze case details, identify root causes, and determine effective resolutionsCollaborate with cross-functional teams to drive timely and accurate case outcomesDraft clear, professional, and comprehensive written responses addressing consumer concernsInterpret and apply ACA, CMS, and State-Based Exchange regulations in all caseworkIdentify trends and recommend process improvements to enhance operational performanceProvide regular status updates on open cases and assigned workSupport team training and knowledge sharingEnsure a positive member experience through accurate, timely, and compliant resolutionsPerform additional duties as assignedBachelor's degree preferred 2–3 years of experience in the healthcare industrySkills & ExperienceWorking knowledge of healthcare operations such as billing, claims, enrollment, benefits, accounts receivable/payableStrong analytical, investigative, and problem-solving skillsExcellent written and verbal communication skills, with the ability to clearly explain complex informationAbility to interpret regulations and apply them in real-world scenariosHighly organized, detail-oriented, and able to manage multiple prioritiesSound judgment and decision-making skillsAbility to thrive in a fast-paced, evolving environmentProficiency in Microsoft Office (Excel, Access, Word, PowerPoint, Outlook)Familiarity with ACA, CMS, and State-Based Exchange regulations is a plusIBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.