Employer Service Representative

About the Opportunity

The Employer Services Representative acts as the primary contact for employer groups and brokers within a mid-size TPA setting. This role is responsible for supporting daily client service operations related to benefits administration, eligibility, billing, enrollment, claims coordination, and employer account maintenance. The position contributes by ensuring accurate, timely, and professional support while fostering strong relationships across clients, internal teams, carriers, and vendors.

Responsibilities

• Serve as main contact for assigned employer groups on benefits administration and service inquiries
• Respond to employer, broker, and member requests via phone, email, and ticketing systems within service standards
• Educate employer groups on TPA processes, policies, eligibility rules, and available services
• Build and maintain positive relationships with clients and brokers
• Cook up and maintain relationships with claims, provider relations, and stop-loss departments to resolve escalated issues
• Research claim status inquiries and facilitate timely resolutions
• Track and document service issues to ensure resolution and client satisfaction
• Maintain confidentiality and comply with HIPAA and company policies
• Accurately document client interactions and account activity in internal systems
• Support audit requests and reporting needs
• Support employer implementations and renewals
• Identify opportunities for process improvement and enhanced client experience
• Participate in employer implementations and renewals
• Support special projects and cross-functional initiatives as assigned

Qualifications

• High school diploma or equivalent required; associate or bachelor's degree preferred
• Minimum 2 years customer service or account management experience in healthcare, insurance, benefits administration, or TPA operations
• Preferred experience in self-funded health plans or TPA environments
• Preferred knowledge of ERISA, COBRA, HIPAA, and ACA requirements
• Experience working with brokers, employer groups, and carrier partners
• Working knowledge of group health benefits, eligibility, claims processing, and billing practices
• Proficiency with Microsoft Office Suite and ability to learn multiple administrative systems
• Strong attention to detail and organizational skills
• Clear and confident communication skills for internal and external customers

Pay Range and Compensation Package

Pay range: $50,000—$55,000 USD
Compensation commensurate with experience and qualifications
Eligibility for bonuses, merit increases, and potential sales commissions depending on role

Equal Opportunity Statement

Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.