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 various related matters for our clients' administrators and employees.

• This role involves close collaboration 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 how to maximize their benefits and guide them towards cost-effective plan options.

• Keep detailed records of client interactions, enter data into Salesforce, and generate necessary client analysis reports.

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

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

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

• 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 matters.

• Handle member eligibility inquiries, manage enrollment entry, and confirm coverage.

⛳️ Requirements

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

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

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

• Familiarity with benefit summaries and Benefit Plan Descriptions.

• Excellent verbal and written communication skills.

• Superior organizational and multi-tasking abilities.

• Strong problem-solving capabilities.

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

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

• A collaborative team player.

• Adaptability and attention to detail.

• Proficient in Microsoft Office Suite.

🏝️ Benefits

• FRP provides a wide range of health-related benefit options, including medical, vision, and dental coverage.

• We offer a 401(k) plan with a company match.

• Company-paid life insurance.

• Short-term and long-term disability coverage.

• Generous PTO policy starting at 18 days per year, in addition to 10 paid holidays and 2 floating holidays!