Employee Benefits Customer Service Representative

This is a fully remote position, open to applicants in Florida, +1 more state.

📋 Description

• The Employee Benefits Customer Service Representative is responsible for resolving claims, addressing benefits inquiries, managing coverage eligibility issues, and handling related matters for our clients' administrators and employees.

• They collaborate closely with clients and carriers through phone and email to resolve issues within a 24-hour period.

• Respond to client employee insurance inquiries, provide answers to benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications.

• Educate client employees on effective benefit utilization and offer guidance on cost-efficient plan options.

• Keep comprehensive records of client interactions, inputting data into Salesforce and generating client analysis reports as needed.

• Utilize Salesforce to collect client information and improve service quality.

• Track resolution timelines to ensure that benefit issues and claims are concluded within the specified timeframe.

• Review Summary Plan Descriptions (SPDs) and benefit summaries for precision.

• Provide expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions to clients.

• Serve as a primary resource within the team, delivering outstanding customer service and support in resolving insurance and benefit-related issues.

• Handle member eligibility inquiries, enrollment processes, and confirmation of coverage.

⛳️ Requirements

• A minimum of three years of experience in a customer service or call center environment.

• Background with an insurance industry carrier, broker, or related vendor.

• Understanding of eligibility claims, medical coding, and billing.

• Familiarity with benefit summaries and Benefit Plan Descriptions.

• Exceptional verbal and written communication skills.

• Excellent organizational and multi-tasking abilities.

• Strong problem-solving capabilities.

• Ability to take initiative, prioritize tasks, and meet stringent deadlines.

• Proficiency in Spanish (both written and spoken) is advantageous.

• A cooperative team player.

• Adaptable and detail-oriented.

• Proficient in the Microsoft Office Suite.

🏝️ Benefits

• FRP offers a comprehensive array of health-related benefits, including medical, vision, and dental coverage.

• We provide a 401(k) plan with company matching.

• Company-paid life insurance.

• Short-term disability (STD) and long-term disability (LTD) coverage.

• Generous paid time off policy beginning at 18 days per year, along with 10 paid holidays and 2 floating holidays!