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Welcome to a team of caring and passionate people who work each day to meet the needs of our members and clients. At Health Benefits, (a subsidiary of Health Care Service Corporation), you will be part of an organization committed to offering custom services to self-funded health benefits plans that manage costs – without compromising benefits – by offering innovative solutions, flexibility, transparency, and customer support. We are now a subsidiary of Health Care Service Corporation, the largest customer-owned insurance company in the United States and a strategic partner of Health Benefits since 2018, giving us access to increased national scale and support. This is an exciting time to join our team and enhance our culture that emphasizes caring, diversity and inclusion, mutual respect, collaboration, and service to our communities.
Health Benefits is seeking an internal associate for an Employer Service Representative position. This position is responsible for working with external customers to resolve claim and customer service issues initiated by clients or Client Management. Responsibilities include research and resolution of issues; recommendations for improvement of processes and procedures to eliminate recurrence of issues; communication with clients, Operations and Client Management; and tracking/monitoring of issues.
Job Responsibilities include:
- Research and resolve claim inquiries initiated by clients and/or brokers.
- Provide written or verbal status updates and explanations to clients, brokers, or Client Management regarding issues.
- Follow-up regularly on outstanding inquiries to ensure timely resolution and client satisfaction.
- Appropriately notify, refer, or escalate inquiries.
- Track issues and document resolution.
- Provide impact reports to Claims & Client Management on a regular basis and/or as needed.
- Recommend process improvements, procedural changes, or other actions to eliminate trends/issues.
- Develop and maintain relationships with select clients, Client Management and Claims & Customer Service personnel.
- Participate in client facing meetings/presentations as needed in office or onsite as necessary.
- Complete special client requests or projects, as directed.
- Other duties as needed/assigned
Job Qualifications:
- High School diploma or GED equivalent
- Prior claim processing/health insurance experience
- Ability to work in a fast-paced, client centric environment
- Excellent verbal and written communication skills
- Ability to research and summarize findings and develop solutions or recommendations for resolution
- Ability to work effectively with employees/members, providers, clients, and various levels of staff
- Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Flexible; open to continued process improvements
- Self-directed individual who works well with minimal supervision
- Good leadership, organizational and interpersonal skills
- Demonstrated critical thinking skills
- Ability to effectively handle varying situations and reach resolution
- Ability to adapt to various system platforms, and to effectively use MS Excel/Word
- Experience presenting and explaining benefits to an individual or group is a plus
- 3+ years of claim processing is a plus
At Health Benefits, you will be part of an organization committed to offering meaningful benefits to our associates to support their life outside of work. From health and wellness benefits, 401(k) savings plan, a minimum of 15 days of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, new parent paid leave, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time associates.
The compensation range for this Employer Service Rep role is $40,392 to $75,845. The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan.
All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, sexual identity, age, veteran, or disability.
Required Skills
Required Experience
