Employee Experience Specialist (TEMP)

Position Summary

Employee Experience Team Specialists serve as the pulse of the member experience, providing first-line support to HR administrators, employees, and brokers. This role focuses on resolution quality, trend detection, and creating positive outcomes for all customer interactions.

Primary Responsibilities

• Customer Experience (HR Admin Support)

• Provide HR admin platform support and troubleshooting
• Aid with census management and data questions
• Support enrollment dashboard usage and navigation
• Handle funding and invoice inquiries
• Manage and resolve Zendesk tickets efficiently

• Employee Experience (Employee Support)

• Handle employee situations and general benefits inquiries
• Research carrier databases for in-network providers
• Research carrier formularies for covered medications
• Aid with general plan information and benefits explanations
• Participate in merged calls with insurance carriers to resolve member issues
• Work directly with insurance carrier representatives to research, coordinate, and resolve complex member escalations, including eligibility, enrollment, billing, claims, provider network, and coverage issues

• Assist employees with shopping and plan comparison
• Provide platform navigation assistance to employees
• Resolve member portal access issues
• Help interpret carrier communications
• Process Qualifying Life Event (QLE) support requests
• Support new hire enrollment assistance

• Document interactions thoroughly in Zendesk
• Identify and escalate patterns and systemic issues
• Contribute to knowledge base and self-service resources
• Participate in continuous improvement initiatives

Key Performance Indicators

• First Call Resolution (FCR): ≥ 80%

• Response Time: CSAT Score: ≥ 95%

• Member Coordination: Effective cross-team collaboration

• Pulse of the Member: Proactive trend identification and reporting

• Member Outcome Result Metrics: Focus on positive resolution outcomes

• Extreme Visibility: Effective communication of insights to broader team

• Resolution Classification Model: All Interactions Are Categorized By Outcome

• Positive Outcome: Issue fully resolved, customer satisfied

• Negative Outcome: Unresolved, customer dissatisfied, or negative impact

• Neutral Outcome: Information provided, no clear resolution needed

Requirements

• Education & Experience

• High school diploma required; Associate's or Bachelor's degree preferred
• 1–3 years of customer service experience, preferably in healthcare, employee benefits, or health insurance
• Call center or help desk experience preferred
• Experience working directly with health insurance carriers to resolve complex member escalations, including eligibility, enrollment, billing, claims, provider network, and coverage issues
• Experience working at a health insurance carrier
• Bilingual (English/Spanish) strongly preferred

• Skills & Competencies

• Communication: Excellent verbal and written communication skills
• Empathy: Genuine care for helping customers resolve issues
• Problem Solving: Ability to think critically and troubleshoot
• Multi-tasking: Can manage multiple conversations and priorities
• Patience: Remains calm and professional under pressure
• Learning Agility: Quick to learn new products, processes, and systems
• Technical Skills: Proficiency with Zendesk or similar ticketing systems
• Comfortable navigating multiple software platforms simultaneously
• Strong typing and data entry skills
• Basic understanding of health insurance and benefits concepts

Success Profile

• You Will Thrive If You Are:
• Energized by helping people solve problems
• Take pride in delivering excellent service experiences
• Can identify patterns across multiple interactions
• Focus on resolution quality over just closing tickets
• Enjoy being a voice for the customer
• Are comfortable with ambiguity and evolving processes

Primary Failure Risks to Avoid

• Closing vs. Resolving: Prioritizing ticket closure over actual resolution
• Missing Escalation Triggers: Failing to escalate issues that need higher-level attention
• Poor Documentation: Inadequate notes that make follow-up difficult
• Strategic Importance: Employee Experience Insights Inform Product friction signals and improvement opportunities
• Carrier performance patterns and issues: Systemic failure points requiring process changes
• Early warning signs of retention risk

Compensation

• This is a 100% remote position (aligned with US Pacific Time)
• An hourly wage of $25 per hour
• Anticipated start date: August 10, 2026
• This is a Temporary Assignment: Duration 6 months, Hours: Monday - Friday 7AM-5PM PT