Accident & Sickness Representative

Associated Administrators LLC; Sparks (NV); On-site; USD 22,000 - 31,000; Full time

Benefits offered by this job

Health, vision and dental coverage

401(k) with company match

Paid time off (PTO)

Growth opportunities

Job summary

Zenith American Solutions is seeking an Accident & Sickness Representative to support participants and beneficiaries with eligibility, benefits, and claims status. The role requires handling PHI/PII with integrity and providing accurate, timely information.

The position emphasizes strong communication, documentation, and adherence to plan requirements. Candidates should be proficient with MS Office and capable of working in a team-oriented environment.

Qualifications

• Minimum high school diploma or GED is required.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Proficient computer skills including MS Office tools and applications.

Responsibilities

• Provides customer service to participants, beneficiaries, and union locals regarding eligibility, benefits and claims status.
• Documents inquiries and updates files with notes of conversations or actions taken.
• Sends required forms and initiates Action Requests for stop pay, return to work, or address changes.
• Follows up to ensure successful completion of requests and resolves complex calls.
• Performs other duties as assigned.

Skills

Customer service

Team player

Integrity

Communication skills

Organization

Reading & interpreting documents

MS Office

Education

High school diploma or GED

Tools

MS Office

Job description

Position Summary

The Accident & Sickness Representative provides customer service to participants, beneficiaries, union locals, regarding eligibility, benefits, and claims status. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Key Duties and Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions.
• Provides verbal and/or in person customer service, responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
• Updates files, including documenting system notes of conversations or action taken.
• Performs tasks associated with the administration of health and welfare benefits such as sending required forms as requested by members.
• Initiates Action Requests to department requesting stop pay, return to work, address change as necessary.
• Follows up to ensure successful completion of Action Request.
• Researches and resolves complex calls.
• Performs other duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Six months of experience working in customer service, third-party administrator processing, or benefits administration.
• Strong work ethic and team player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong detail orientation and listening skills.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Proficient computer skills including MS Office tools and applications.

Preferred Qualifications

• Call center experience in benefits claims and multiple funds.
• Bilingual a plus.

*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.

Working Conditions/Physical Effort

Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.

Disability Accommodation

Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at [e-mail], and we would be happy to assist you.

Compensation

Compensation: $19.00/hr Zenith American Solutions Real People. Real Solutions. National Reach. Local Expertise. We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.

About Zenith American Solutions

Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before. We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American! We realize the importance a comprehensive benefits program to our employees and their families.

Benefits

As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!

Culture

At Zenith American Solutions, we take immense pride in fostering a positive, respectful, and supportive work environment that provides challenging opportunities while supporting a healthy work/ life balance. Our organizational culture is founded on principles of integrity, honesty and respect for all stakeholders, including our employees, clients, and business partners. With a low employee turnover rate and a high rate of internal promotions and transfers, the Zenith team is proud to be a part of an 80-year legacy of excellence. Our employees embody a spirit of integrity, take immense pride in their work, and are enthusiastic about referring others to join our team.