Department Bios

A most crucial component of a successful plan – as well as employee satisfaction – is responsive, helpful member service. Our Member Service Representatives train extensively to ensure the highest quality service in the industry. Member Service Representatives work one-to-one with hundreds of members daily to help them understand their accounts and answer any and all questions. Further, they routinely coordinate calls among members, providers and carriers to sort out billing and payment questions.

Member Service Representatives can be reached via phone, email, or live chat from 8:00 am ET to 7 pm ET Monday through Thursday, and from 8:00 am ET to 5:00 ET on Fridays

Our Client Service Department is the primary contact for Choice Strategies’ valued clients and brokers. Each client is provided with a Client Service Team to ensure smooth plan functioning and quick problem resolution. Representatives also act as an informational resource for our clients. Client Services contributes to the overall success of Choice Strategies, maintaining and continuously improving our client relations to provide the highest level of service in our industry.

Choice Strategies’ Sales Department develops and maintains relationships with Broker’s, General Agent’s and Marketing Agents.  The Sales Team assists brokers and clients to help design/select plans that best meet their healthcare cost goals, provide support in the completion and submission of the New Group Submission Form/Master Application and facilitate initial enrollment/benefit meetings with brokers. Our Sales Department also provides broker training through webinars and Brainshark presentations and serves as an informational reference for brokers.  

The Installation Department is responsible for reviewing and processing new client information, including the set-up of employer demographic information, plan designs and plan documents.  Installation specialists work closely with our broker clients and sales team, developing the best possible methods for administering a wide variety of plan options to fit the needs of each individual employer.

The Eligibility Department is responsible for processing new employee enrollments as well as any changes to existing member accounts.  For example, should there be a need to end an employee’s coverage or make changes regarding how he or she participates in the plan, an Eligibility Specialist would process the request.  Each time an enrollment or change is processed, a confirmation is sent to the individual who originated the request as well as any necessary contacts designated for that employer.  The Eligibility Department also identifies and implements enhancements to the enrollment process to improve the experience for our Brokers, Employers and their Employees.

The Renewal & Plan Maintenance Department is responsible for creating a seamless transition for each employer client from one plan year to the next.

In addition, Renewal Analysts maintain employer demographic and plan information should there be the need for any changes.  If an employer desires to change his or her plan design, a Renewal Analyst would interface with our Client Service Team to develop the best alternatives possible and process the changes accordingly.

Choice Strategies’ POS Verification Department, also known as Account Services, is responsible for auditing member transactions made with the Choice Strategies to ensure that charges are eligible IRS expenses and allowed on the member’s plan. The department processes hundreds of transactions per day. For charges that require supporting documentation in order to ensure the charge is eligible, members will receive a letter requesting the appropriate supporting documentation for their charge.

The Claims Department is responsible for the processing of manual claims submitted by our members.  Members who don’t have cards -- or those who may have previously incurred out-of-pocket expenses -- can submit a manual claim including documentation proving it is an eligible expense (Ex. Explanation of Benefits, or detailed statement). This can occur either through their online account or via e-mail, mail or fax.  Our Claims analysts use the documentation to determine if the expense is eligible within the member’s plan guidelines. If approved, the member is reimbursed via the method most convenient for them, either by direct deposit or check.

The Data Feed Department receives health carrier claim data and can either approve member’s card charges directly from the data feed or pay members directly from the data feed for payable medical expenses. With certain carriers, the Data Feed Department can even pay providers directly from a member’s account for eligible amounts owed.

Our Substantiation Department collects information from a member’s carrier online account information when a member submits a HIPAA Release Form. This login account information allows Substantiation to automatically approve card charges without requesting that a member submit supporting documentation.

Our Reception Department serves as the initial point of contact for Choice Strategies. Through directing phone calls from members, employers and brokers, as well as moving email, mail and fax to the appropriate Departments for processing, Reception serves as an integral part in keeping operations at Choice Strategies running smoothly.