Benefits & Eligibility Specialist

Zenith American Solutions, Inc.; Bothell (WA); On-site; USD 38,572 - 44,083; Full time

Job summary

Zenith American Solutions, Inc. seeks a Customer Care Advocate to support participants, beneficiaries, union locals and providers with eligibility, benefits, and claims status.

The role emphasizes integrity, accurate documentation, and clear communication. You will work with retirement and health plans, handling inquiries and processing enrollments in applicable systems, while upholding regulatory requirements.

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.

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 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 retirement and health and welfare benefits such as:
• Processing and/or sending mailers or required forms as requested by members.
• Processing and/or sending correspondence related to member or claims status.
• Processing enrollments and updating member information in applicable system(s).
• Distributing 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 Request.
• Researches and resolves complex and technical issues and irregularities.
• Performs other duties as assigned.

Skills

Customer service

Communication

Integrity

Organization

Reading/interpretation

Education

High school diploma or GED

Tools

MS Office

Job description

Zenith American Solutions, Inc. seeks a Customer Care Advocate to support participants, beneficiaries, union locals and providers with eligibility, benefits, and claims status.

The role emphasizes integrity, accurate documentation, and clear communication. You will work with retirement and health plans, handling inquiries and processing enrollments in applicable systems, while upholding regulatory requirements.