Employee Benefits Customer Service Representative

Job Summary

Handling claims resolution and benefits inquiries, the remote Employee Benefits Customer Service Representative will assist clients' administrators and employees with coverage eligibility concerns and related issues while ensuring timely resolutions within a 24-hour timeframe.

Key responsibilities

• Address client employee insurance concerns and assist with claims resolution and pre-certifications
• Educate client employees on benefit utilization and provide guidance on cost-effective plan options
• Maintain detailed records of client interactions and monitor resolution timelines for benefit issues and claims

Required qualifications

• Three plus years' experience in a customer service or call center environment
• Experience with an insurance industry carrier, broker, or insurance-related vendor
• Knowledge of eligibility claims, medical coding, and billing
• Familiarity with benefit summaries and Summary Plan Descriptions (SPDs)
• Proficiency in Spanish (both written and spoken) is a plus