Employee Benefits Advocate

Essential Functions

• Address client employee insurance concerns, answer benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications.
• Educate client employees on optimal benefit utilization and provide guidance on cost-effective plan options.
• Maintain detailed records of client interactions, entering data into Salesforce and generating client analysis reports as necessary.
• Use Salesforce to gather client information and enhance service quality.
• Monitor resolution timelines to ensure benefit issues and claims are closed within the designated timeframe.
• Review Summary Plan Descriptions (SPDs) and benefit summaries for accuracy.
• Offer expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions to clients.
• Act as a primary resource within the team, delivering exceptional customer service and support in resolving insurance and benefit-related issues.
• Address member eligibility inquiries, enrollment entry and confirmation of coverage.

Competencies & 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.
• Proficiency in Spanish (both written and spoken) is a plus.
• Collaborative team member.
• Adaptable and detail-oriented.
• Proficient in Microsoft Office Suite.

Education & Experience

• 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.

Pay Transparency Range

$22 - $25 USD

Benefits

• Comprehensive range of health-related benefit options including medical, vision, and dental.
• 401(k) with company match.
• Company paid life insurance.
• STD, LTD and a generous PTO policy starting at 18 days per year plus 10 paid holidays & 2 floating holidays!