Job Description

Job Description

Job Description

Key Responsibilities

• Respond to inbound calls and emails regarding employee benefits, including plan details, eligibility, coverage, claims, and enrollment.
• Assist members with navigating online portals or completing forms related to benefit elections and changes.
• Educate callers on benefits, deadlines, and regulatory notices (e.g., COBRA, HIPAA, ACA).
• Troubleshoot and resolve issues related to claims processing, benefit cards and logging into portal.
• Maintain up-to-date knowledge of company-sponsored benefit plans and compliance regulations.
• Accurately document all interactions in Salesforce the customer relationship management system.
• Escalate complex or urgent matters to appropriate internal teams, broker or employer contact.
• Adhere to privacy and confidentiality standards, including HIPAA and PHI compliance.

Qualifications

• High school diploma or equivalent required; associate or bachelor’s degree preferred.
• 1+ year of call center or customer service experience, preferably in benefits, insurance, or healthcare.
• Familiarity with benefit terminology (e.g., PPO, HMO, FSA, 401(k)) and processes is strongly preferred.
• Strong communication, problem-solving, and time management skills.
• Proficient with computer systems and customer databases; ability to learn proprietary systems quickly.
• Must maintain a high level of professionalism and confidentiality.

Job Tags

Similar Jobs