Transplant Benefit Specialist

Shift

Shift: Saturday & Sunday required and 3 additional days during the week.

Location

Location: Virtual

About the role

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Responsibilities

• Ensures accurate transplant benefit administration for all lines of business.
• Interfaces daily with providers and members to resolve benefit issues and provide education where needed.
• Analyzes components of benefits and alerts management of risks.
• Interprets benefits and interfaces with members and providers to give benefit information.
• Prepares individual benefit quotes for members and providers for transplant benefits.
• Identifies high risk cases and alerts management.
• Interfaces with internal and external representatives on benefit issues.
• Creates new cases in the Medical Management System with accurate benefit, group and provider information.
• Creates Case Management Folders and determines initial acuity level of case.

Qualifications

• Requires HS diploma or equivalent and a minimum of 3 years related experience; or any combination of education and experience which would provide an equivalent background.
• Preferred Skills, Capabilities, And Experiences: Knowledge of health benefits and medical terminology strongly preferred.

Benefits

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Pay

Market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Schedule

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Company Information

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.