Employee Benefits Customer Service Representative

The role

The Employee Benefits Customer Service Representative handles claims resolution, benefits inquiries, and coverage eligibility concerns for clients' administrators and employees. They work with clients and carriers via phone and email to resolve matters within a 24-hour timeframe.

What you will do

• Address client employee insurance concerns and answer benefit-related questions
• Assist with claims resolution, patient advocacy, and pre-certifications
• Educate client employees on benefit utilization and cost-effective plan options
• Maintain detailed records of client interactions in Salesforce
• Generate client analysis reports
• Monitor resolution timelines to ensure issues and claims are closed within the designated timeframe
• Review Summary Plan Descriptions and benefit summaries for accuracy
• Offer expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions
• Address member eligibility inquiries, enrollment entry and confirmation of coverage

Required qualifications

• Exceptional verbal and written communication abilities
• Outstanding organizational and multi-tasking capabilities
• Strong problem-solving skills
• Skilled at taking initiative, prioritizing tasks, and meeting tight deadlines
• Collaborative team member
• Adaptable and detail-oriented
• Proficient in Microsoft Office Suite
• Three plus years’ experience working in customer service/call center environment
• Experience with an insurance industry carrier, broker, or insurance related vendor
• Knowledge of eligibility claims, medical coding and billing, etc.
• Knowledge of benefit summaries and Benefit Plan Descriptions

Nice to have

• Proficiency in Spanish (both written and spoken) is a plus

Benefits

• Medical
• Vision
• Dental
• 401(k) with company match
• Company paid life insurance
• STD
• LTD
• PTO starting at 18 days per year
• 10 paid holidays
• 2 floating holidays

About the company

Foundation Risk Partners is one of the fastest growing insurance brokerage and consulting firms in the US.