Benefits Support Specialist: Claims & Coverage Expert

Foundation Risk Partners, Corp.; Philadelphia (Philadelphia County); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Health benefits

401(k) with company match

Life insurance

STD/LTD

PTO 18 days + holidays

Job summary

Foundation Risk Partners, Corp. is seeking an Employee Benefits Customer Service Representative to handle benefits inquiries, claims resolution, and eligibility questions for clients and employees.

You will work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe. The role requires strong communication, organization, and problem-solving skills, with experience in a call center or insurance environment.

Qualifications

• 3+ years in customer service/call center environment
• Experience with an insurance industry carrier, broker, or insurance related vendor
• Knowledge of eligibility claims, medical coding and billing
• Knowledge of benefit summaries and Benefit Plan Descriptions
• Proficiency in Spanish is a plus
• Strong communication and service orientation

Responsibilities

• Address client employee insurance concerns and assist with claims resolution and enrollment.
• Educate client employees on benefit utilization and plan options.
• Maintain records and enter data into Salesforce; generate client analysis reports.
• Use Salesforce to gather client information and improve service quality.
• Monitor resolution timelines to ensure timely closure of issues.
• Review SPDs and benefit summaries for accuracy.
• Provide expertise on insurance billing, coding, and plan descriptions to clients.
• Serve as a primary resource within the team for issue resolution and customer support.

Skills

Verbal & written comms

Organization & multitasking

Problem solving

Initiative & prioritization

Team collaboration

Detail-oriented

Microsoft Office

Spanish (nice to have)

Tools

Salesforce

CRM software

Job description

Foundation Risk Partners, Corp. is seeking an Employee Benefits Customer Service Representative to handle benefits inquiries, claims resolution, and eligibility questions for clients and employees.

You will work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe. The role requires strong communication, organization, and problem-solving skills, with experience in a call center or insurance environment.