What You’ll Do

• Process a variety of requests, inquiries and transactions via phone, email,andfax

• Review requests to ensure accuracy

• Support internal & external customers via phone or email, and fax

• Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route toappropriate areafor follow up as applicable

• Gather and analyze data to provide feedback to Team Leads on employee development needs and/or specific providers requiring education on prior approval or pre-certification process 

• Screen inquiries todetermineif authorization isrequired

• Verify member benefits and eligibility and/or provider setup.

• Maintain and update Service Requests and research incorrect or missing information.

• Triage and assign all incoming inquiries ina timely, efficient manner throughout the day toappropriate staff

• Perform Peer Audits monthly asrequired

• Provide clinical review outcome notification to members and providers (verbal and written)

What You Bring

•  High school diploma or GED

• 3+ years of experience in relatedfield

Bonus Points 

• Demonstrates the ability to work independently with minimal supervision

• Strong problem-solving skills with a proactive, results-driven mindset

• Self-starter witha high levelof initiative and accountability

• Proficient in Microsoft Office Suite, including Word, Excel, and related tools

• Background or experience in the insurance industry preferred

What You’ll Get 

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community  

• Work-life balance, flexibility, and the autonomy to do great work   

• Medical, dental, and vision coverage along with numerous health and wellness programs   

• Parental leave and support plus adoption and surrogacy assistance   

• Career development programs and tuition reimbursement for continued education   

• 401k match including an annual company contribution   

• Learn more   

WhereYou’llWork

Our Hybrid Flex approach is builton presencewith a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplacethat’sflexible, connected, and future focused.

In a Hybrid-Flex role,you’llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you’llwork virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process.

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