Benefits & Claims Support Specialist

zenithamerican; Alameda (CA); On-site; USD 25,000 - 34,000; Full time

Job summary

Zenith American Solutions is seeking a Customer Care Advocate to provide service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. You will maintain plan knowledge, document inquiries, and update member information in applicable systems.

The role requires strong communication, organizational skills, and attention to detail, with duties including processing enrollments, sending materials, and supporting regulatory communications.

Qualifications

• High school diploma or GED.
• Six months of experience in customer service or benefits processing.
• Strong work ethic and team player mentality.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong detail orientation and listening skills.
• Proficient computer skills including MS Office tools and applications.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to and documenting inquiries in accordance with various Plan(s) benefits.
• Updates files, including documenting system notes of conversations or action taken.
• Performs tasks related to administration of retirement and health and welfare benefits (enrollments, updates, mailers).
• Distributes communications related to regulatory requirements.
• Initiates Action Requests to departments for adjustments to claims, retirement, and/or eligibility and follows up.
• Researches and resolves complex and technical issues and irregularities.
• Performs other duties as assigned.

Skills

Customer service

Communication skills

MS Office

Organization skills

Attention to detail

Education

High school diploma or GED

Job description

Zenith American Solutions is seeking a Customer Care Advocate to provide service to participants, beneficiaries, union locals, and providers regarding eligibility, benefits, and claims status. You will maintain plan knowledge, document inquiries, and update member information in applicable systems.

The role requires strong communication, organizational skills, and attention to detail, with duties including processing enrollments, sending materials, and supporting regulatory communications.