Benefits Navigation Specialist

Job Summary:

As a Benefits Navigation Specialist (BNS) at Medefy Health you will be responsible for assisting with the administration, navigation, and explanation of company benefit plans serviced by the Medefy app.   Benefits Navigation Specialists will educate plan members on their specific benefits plans, answer benefits, claims, pharmacy, healthcare questions and lead users to low-cost, high-quality doctors and facilities in a friendly and time‐sensitive manner all through live chat via the Medefy platform. The goal of the Benefits Navigator is to use their skill, knowledge, and friendly attitude to assist plan members through a successful and pleasant benefits and healthcare journey.  

About our awesome company, Medefy Health

Medefy Health (www.Medefy.com) is a leading SaaS benefits navigation company, dedicated to simplifying the way employees’ access and utilize their benefits. Our mission is to drive better health and financial outcomes for our users while supporting HR teams and broker partners with seamless, data-driven solutions. 

Our company is headquartered in Tulsa, OK. We’re proud to be Oklahoma’s #1 fastest-growing company and rated by Inc. Magazine as the 37th fastest-growing tech company and the 288th fastest-growing company overall in the USA, and our story is still being written!

Healthcare is only getting more complicated, and more expensive, for employers and their employees. This is where Medefy Health comes in. We’re on a mission to eliminate the stress on hard-working families caused by an impossible to navigate healthcare system. All while saving them, and their employers, a significant amount of time and money. We demolish barriers between healthcare and the people who need it, and we need your help to further our mission!

Job Duties & Responsibilities:

• Monitor and respond to incoming user chats in a friendly, timely (2 minutes or less), and HIPAA‐compliant manner via computer-based applications  
• Answer users’ benefits questions, health insurance questions, coverage questions, and other related inquiries via chat feature on the Medefy app 
• Assists app end users with benefits claim issues and plan changes 
• Stay familiarized with the details of Medefy client company health plans, third party vendors, health insurance, benefits details, and other relevant items necessary to facilitate user solutions, including client health plan changes, amendments, and alterations  
• Stays familiarized with Medefy software platform tools, HIPAA, and office policies  
• Work hand‐in‐hand with other Medefy departments to help users successfully complete their health care journey  
• Follow‐up with users to ensure they had a pleasant encounter and successful outcome  
• Provide above and beyond service and professional 
• Create referrals for the Referral Coordinators to process 
• Performs other related duties as assigned 

You must have at least the following: 

• Associate degree in HR or related field, but experience and-or other training or certification may be substituted for education 
• 1 year experience in HR and-or benefits administration and applicable laws 
• Proficiency with computers, Microsoft Office, apps and instant messaging  
• Proficiency with text-based communication in real-time 
• Type at least 50 words per minute   
• Effective communication skills; verbal and written in English 
• Reading comprehension proficiency   
• A good general knowledge of the general healthcare ecosystem and trends 
• A relentlessly inquisitive nature, love researching and finding new answers 
• A professional demeanor, especially when assisting others who are experiencing challenges 
• Excellent organizational and time management skills 
• The ability to multitask, while working both quickly and efficiently 
• Willingness to cover night and weekend on-call shifts, if or when required  
• Friendly and helpful personality, who cares about helping others 

It would be great if you have:

• Bachelor’s degree in human resources or related field of study 
• SHRM Certified Professional (SHRM-CP) or HRCI Professional in Human Resources (PHR) SHRM certification credentials. 
• 2+ years’ experience working in health insurance or benefits (e.g. health brokerage, insurance, benefits advisory, insurance adjustment, etc.) fields  
• Bilingual - verbal and written in Spanish 
• In-depth knowledge of the health insurance processes, including claims processing, explanation of benefits formatting, and standard medical industry charge-off practices 
• In-depth understanding of healthcare referral management practices with the ability to effectively communicate these practices to consumers 

Supervisory Duties: No supervisory duties

Travel Requirements Percentage: None - 0%

Physical and Mental Requirements:

Remote Work Environment: This position is performed remotely in a home-office setting. The employee must ensure a quiet, private workspace free from distractions and suitable for video conferencing and focused work. A reliable high-speed internet connection is required.

Physical Demands:

• Prolonged periods of sitting at a desk and working on a computer (up to 8+ hours per day).
• Frequent use of a computer keyboard, mouse, and screen; ability to type at least 55 WPM.
• Occasional movement within the home office environment (e.g., retrieving office supplies or documents).
• Vision abilities required include close vision for computer use and reading documentation, with or without corrective lenses.
• Occasional light lifting of materials (up to 15 lbs), such as a laptop or office equipment, may be required.

Communication Requirements:

• Must be able to communicate effectively in English using written and verbal channels (email, chat, video conferencing, phone).
• Must be able to read and interpret complex written information such as healthcare documentation, performance reports, and company procedures.
• Must be responsive and present during scheduled working hours and team communications, including virtual meetings and collaboration platforms.

Cognitive and Emotional Demands:

• Ability to manage multiple complex tasks and competing priorities in a high-paced environment.
• Strong critical thinking and decision-making skills with attention to detail.
• Ability to exercise independent judgment and problem-solving under time constraints.
• Must be able to adapt quickly to changing workflows, operational needs, and team dynamics.
• Must maintain a high level of confidentiality and discretion in handling sensitive information.
• Requires emotional resilience, especially when assisting users in distress or resolving escalated member concerns.
• Must be able to maintain composure and a professional demeanor under pressure.

Work Schedule & Attendance:

• Must be punctual, dependable, with potential for on-call duties as needed.
• Must maintain regular attendance and meet performance expectations without direct on-site supervision.

**Job description is not a comprehensive listing of all the activities, duties or responsibilities that are required of the employee.  Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.