The customer service representative is responsible for providing customer service and support to employee benefits' customers. The representative will be providing support to the Account Management team in responding to customer inquiries, providing information about services, processing eligibility, claims and resolving customer issues. Responsible to compute, classify, and record benefit data to keep benefit records complete and timely processing of eligibility.
Major Responsibilities
Speak with client employees and HR contacts by phone concerning benefit program related questions.
Conducts Open Enrollment and New Hire Meetings and Presentations.
Receive inbound customer service calls.
Process employee Enrollment, Termination and COBRA data into internet-based computer systems using established office procedures or client protocol.
Handle diverse customer service situations between employees, employers and insurance carrier vendors in a professional manner.
Track open carrier or client employee issues and report on progress toward completion.
Assists client contacts with general insurance rules and compliance.
Assists client contacts with claims, grievances, billing inquiries
Assists Account Management team with all areas of benefits administration.
Reviews benefit communication material for accuracy and completeness.
Provides team and client with appropriate timelines to ensure that expectations and turnaround times are met.
Maintains composure and effectiveness under pressure in a deadline driven environment.
Proactively anticipates operational problems and identifies opportunities for improvements to avoid those problems.
Comply with federal, state, and company policies, procedures, and regulations.
Operate 10-key calculators, typewriters, and copy machines to perform calculations and produce documents.
Reconcile or note and report discrepancies found in records for correction.
Perform general office duties, such as filing, answering telephones, and handling routine correspondence.
Performs other duties as assigned or required.
Knowledge Skills and Abilities: • HS Diploma or GED equivalent required. Bachelor's degree preferred. • 2+ years professional experience in a related customer service environment. • Understanding of insurance products • Good knowledge of employee benefit programs administration and eligibility guidelines. • Active Customer Service 4-40, Health 2-40 or Health & Life 2-15 license preferred if not must be obtained within 90 days. • Strong knowledge of Microsoft Office, Word, Excel, and Outlook Exchange; proficient in web browsers. • Zywave system knowledge preferred. • Time Management and Prioritization. • Self Starter, driven, high sense of urgency. • Strong Communication skills verbal and written. Bilingual English and Spanish • Team orientated.