Client Concierge Coordinator

Job Summary:

The Client Concierge Specialist delivers high-touch, white-glove service experience to members, providers, and clients within a health insurance environment. This role serves as a single point of contact, guiding members through their healthcare journey by providing personalized support related to benefits, claims, eligibility, provider navigation, and issue resolution. The goal is that every interaction is handled with ownership and empathy, while employing proactive problem-solving. This position combines strong customer service skills with healthcare knowledge to proactively anticipate needs, resolve inquiries efficiently, and enhance overall member satisfaction.

Duties and Responsibilities:

• Serve as the primary point of contact for inbound calls, emails, and digital inquiries from members and providers
• Deliver personalized, concierge-level service by understanding member needs and providing tailored solutions which include outbound contacts
• Assist members with benefits education, eligibility verification, and plan navigation
• Guide members through claims inquiries, including status, processing, and explanation of benefits (EOBs) ensuring delivery in an understandable, polite manner.
• Support provider searches, appointment coordination, and healthcare navigation
• Research and resolve complex issues related to claims, billing, and coverage
• Investigate and resolve disputes/escalations. This involves research and identifying root causes of denials/underpayments and other errors and gathering what is needed to resolve the issues. Identify the reason for the escalation and provide research until resolution is reached
• Update and maintain accurate records of progress, action taken, pending items and status; communicate updates to internal and external stakeholders. Escalate unresolved or high-impact issue appropriately.
• Meet or exceed performance metrics including quality, accuracy, call handling time, time to resolution, work volume and member satisfaction.
• Deliver empathetic, professional communication and support retention by creating positive and seamless interactions