Senior Benefit Navigator
Position Summary
The Senior Benefit Navigator is a highly experienced client advocate responsible for resolving complex benefit and coverage issues, delivering proactive retention outreach, and ensuring an outstanding customer experience across all product lines. This role serves as a trusted liaison between clients, insurance carriers, healthcare providers, and internal teams.
Key Responsibilities
Serve as the primary point of contact for escalated client concerns, complaints, and complex service issues.
Aid clients with quotes, enrollments, eligibility, claims, billing, reinstatements, and post-enrollment support.
Investigate and resolve urgent situations such as loss of coverage or medical access issues.
Cook up solutions by coordinating with carriers, providers, and internal teams to ensure timely resolution.
Provide education on healthcare plans, benefits, and coverage options.
Conduct needs assessments to identify financial, medical, and social concerns.
Develop personalized action plans and care strategies.
Help clients navigate online portals and self-service tools.
Conduct proactive outreach to at-risk clients.
Identify opportunities to improve retention and engagement.
Analyze customer behavior and trends to recommend retention strategies.
Prepare reports on retention metrics, service trends, and improvement opportunities.
Document all interactions in Salesforce and other systems.
Contribute to SOP development and process improvements.
Support onboarding and training of new team members.
Share best practices and mentor less experienced staff.
Participate in cross-functional initiatives.
Qualifications
High school diploma or GED.
7+ years of experience in customer service, insurance, healthcare, or a related field.
Advanced proficiency with CRM systems (Salesforce preferred) and Microsoft Office, especially Excel.
Strong communication, analytical, and problem-solving skills.
Ability to manage escalations with professionalism and empathy.
Preferred Qualifications
Bachelor’s degree or equivalent experience.
Active Texas General Lines Life & Health Insurance License (or ability to obtain within 90 days; company-sponsored).
Experience with ACA Marketplace and Medicare products.
Bilingual in Spanish or other languages such as Vietnamese, Mandarin, Cantonese, Korean, Arabic, Urdu, Farsi, or Russian.