Benefits & Eligibility Care Specialist

Zenith American Solutions, Inc.; Bothell (WA); On-site; USD 39,000 - 47,000; Full time

Benefits offered by this job

Health insurance

Vision Coverage

Dental Coverage

401(k) with company match

Paid time off

Growth opportunities

Job summary

Zenith American Solutions seeks a Customer Care Advocate to support participants, beneficiaries, union locals, and providers with eligibility, benefits, and claims status. You will maintain plan knowledge, respond to inquiries, document interactions, and process enrollments and correspondence.

Role requires a high school diploma, at least six months in customer service or benefits administration, and strong communication, organization, and integrity.

Qualifications

• High school diploma or GED.
• Six months of experience in customer service, third-party administrator processing, or benefits administration.
• Strong work ethic and team player mentality.
• 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.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and applies knowledge in all job functions.
• Provides written, verbal, or face-to-face customer service by responding to and documenting inquiries in accordance with Plan(s) benefits.
• Updates files, including documenting system notes of conversations or actions taken.
• Processes and/or sends mailers or required forms as requested by members.
• Processes and/or sends correspondence related to member or claims status.
• Processes enrollments and updates member information in applicable system(s).
• Distributes communications related to regulatory requirements.
• Initiates Action Requests to appropriate departments requesting adjustments to claims, retirement, and/or eligibility as necessary.
• Follows up to ensure successful completion of Action Requests.
• Researches and resolves complex and technical issues and irregularities.

Skills

Customer service

Team player

Detail oriented

Written and verbal communication

MS Office proficiency

PHI/PII awareness

Education

High school diploma or GED

Tools

MS Office

Job description

Zenith American Solutions seeks a Customer Care Advocate to support participants, beneficiaries, union locals, and providers with eligibility, benefits, and claims status. You will maintain plan knowledge, respond to inquiries, document interactions, and process enrollments and correspondence.

Role requires a high school diploma, at least six months in customer service or benefits administration, and strong communication, organization, and integrity.