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Claims & Benefits Specialist

AT Accolade
Accolade

Claims & Benefits Specialist

Prague, Czech Republic

About Accolade
Accolade (Nasdaq: ACCD) provides millions of people and their families with an exceptional healthcare experience that is personal, data driven and value based to help every person live their healthiest life. Accolade solutions combine virtual primary care, mental health support and expert medical opinion services with intelligent technology and best-in-class care navigation. Accolade's Personalized Healthcare approach puts humanity back in healthcare by building relationships that connect people and their families to the right care at the right time to improve outcomes, lower costs and deliver consumer satisfaction. Accolade consistently receives consumer satisfaction ratings over 90%. For more information, visit accolade.com.

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You will be a part of a large team of open-minded professionals with diverse backgrounds and experience. You will join a dynamic work environment and have colleagues from all over the world. In your role, Claims & Benefits Specialist are primarily solving inbound tasks and instant messages from our internal team and resolve complex cases regarding claim, benefit, and eligibility issues by using internal tools, health plan insurance systems, and coordinating with our health plan partners.

Working hours:

13.30-22.00 (5 days per week: Mon-Fri)

Start date: 1st November 2024

Location: Prague 8 - Karlin

A day in the life...

  • Act as a trusted partner for complex claims and benefit questions and issue resolutions.
  • Act as a liaison to our health plan partners and providers in solving complex claims and benefit issues.
  • Educate our internal teams by helping them better understand claims and benefit questions/issue resolution and support ongoing training/learning with frontline employees.
  • Collaborate with teammates, member services teams, health plans, and providers to deliver the best possible service experience for clients of the company
  • Handle claim disputes with partner health plans on behalf of the client.
  • Liaise with our Health Plan partners via phone call several times per day to investigate and resolve member issues.
  • Ensure compliance with internal and external health plan partner business processes.
  • Develop and maintain solid working relationships and processes with health plans and other payors.
  • Support internal teams with eligibility, benefits, and claims questions and/or issue resolution, including understanding the root cause of the issue.
  • Listen, assess, and comprehend the clients' presenting issue(s) and use critical thinking, judgment, and problem solving to take appropriate action.
  • Identify opportunities to improve how we resolve claims and benefit issues, including improvements to InView,[KB1] our benefit content, and other tools and resources.
  • Participate in special projects as requested.
  • Provide colleagues with timely and accurate solutions to their client's complex claims problems.
  • Support of client expectations and health plan processing guidelines.

To be successful in this role, it is expected that you have:

  • Excellent knowledge of English language, strong communication skills both in written and verbal
  • Ability to work independently, organize, and prioritize own tasks effectively
  • Previous experience in roles where technology, multi-tasking and verbal/written communication is used to drive their day-to-day responsibilities is an advantage
  • General computer literacy

While working in Accolade you will enjoy the following benefits:

  • Employee Stock Purchase Plan
  • 5 weeks of vacation + personal days
  • 1 paid day off for your volunteerism per year
  • Sodexo Gastro Pass Card with no contribution
  • Home office
  • Flexi Pass Card per month or Multisport Card
  • Parental benefits
  • Yoga classes with a contribution
  • Work from abroad up to 4 weeks a year


  • Virtual hospital service uLekare.cz
  • Head Space Emotional Support app (www.ginger.com)
  • Carrott - support on family forming journey (www.get-carrot.com)

Our people are the Heart of Accolade

Together, we are building a great and enduring business that truly makes an impact. At Accolade, we are committed to building a workplace where all can grow and thrive. We do this by living our core values:

Member Obsessed

For everything we do, we ask ourselves: Is this going to make our member's life measurably better?

Be Fearless

We think differently. We do what's never been done. We are reinventing healthcare every step of the way.

Stronger Together

We honor the differences among one another and know that our unique perspectives drive us forward.

Genuine Care

We care deeply about the human beings we work with and serve. We have each other's back.

Embrace Reality

We bring the data, tell the truth, and trust each other.

Relentless Execution

We operate with a bias for action. Take initiative, move fast & have fun.

Accolade is committed to being a company that embraces a hybrid work environment where employees can enjoy the best of both worlds - the flexibility to work from home and the opportunity to have a common place to connect, collaborate, and innovate with others in-person. Our hybrid work model requires that employees who live within 40 miles of an Accolade office are required to be in the office for at least two days during the work week. Accolade will provide reasonable accommodation to qualified employees with disabilities or for a sincerely held religious belief.

Accolade is an Equal Opportunity and Affirmative Action Employer committed to advancing an inclusive environment for all qualified applicants and employees. We provide employment opportunities, without regard, to any legally protected status in accordance with applicable laws in the US. We are committed to help ensure you have a comfortable and positive interview experience.

Accolade, Inc., PlushCare, Inc., and Accolade 2ndMD LLC will never ask you to pay to get a job. Anyone who does this is a scammer. Further, we will never send you a check and ask you to send on part of the money or buy gift cards with it. These are also scams. If you see or lose money to a job scam, report it to the Federal Trade Commission at ReportFraud.ftc.gov. You can also report it to your state attorney general.

To review our policy around data use, visit our Accolade Privacy Policy Page. All your information will be kept confidential according to EEO guidelines.

Prague

Client-provided location(s): Prague, Czechia
Job ID: accolade-REQ202408-016
Employment Type: Full Time

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • HSA
    • Fitness Subsidies
    • On-Site Gym
    • Pet Insurance
    • Mental Health Benefits
    • HSA With Employer Contribution
  • Parental Benefits

    • Fertility Benefits
    • Family Support Resources
    • Adoption Assistance Program
    • Birth Parent or Maternity Leave
  • Work Flexibility

    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
    • Casual Dress
    • Happy Hours
    • Snacks
    • Company Outings
    • Holiday Events
  • Vacation and Time Off

    • Paid Vacation
    • Unlimited Paid Time Off
    • Paid Holidays
    • Personal/Sick Days
    • Leave of Absence
    • Volunteer Time Off
  • Financial and Retirement

    • 401(K) With Company Matching
    • Company Equity
    • Stock Purchase Program
    • Performance Bonus
    • Relocation Assistance
    • Financial Counseling
  • Professional Development

    • Tuition Reimbursement
    • Promote From Within
    • Shadowing Opportunities
    • Lunch and Learns
    • Leadership Training Program
  • Diversity and Inclusion

    • Diversity, Equity, and Inclusion Program

Company Videos

Hear directly from employees about what it is like to work at Accolade.