Benefits Support Specialist - Claims & Inquiries

Corporate Synergies; Camden (NJ); On-site; USD 30,000 - 34,000; Full time

Job summary

Corporate Synergies is seeking an Employee Benefits Customer Service Representative to handle claims resolution, benefits inquiries, and coverage eligibility for clients’ administrators and employees. You will work with clients and carriers via phone and email to resolve matters within a 24-hour timeframe.

Responsibilities include educating employees on benefit utilization, maintaining records in Salesforce, and reviewing SPDs for accuracy while delivering exceptional customer service.

Qualifications

• 3+ years of customer service/call center experience in insurance or related industry.
• Experience with an insurance carrier, broker, or insurance related vendor.
• Knowledge of eligibility, claims, medical coding and billing, etc.
• Knowledge of SPDs and Benefit Plan Descriptions.

Responsibilities

• Resolve client employee insurance concerns, answer benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications.
• Educate client employees on optimal benefit utilization and provide guidance on cost-effective plan options.
• Maintain detailed records of client interactions, entering data into Salesforce and generating client analysis reports as necessary.
• Use Salesforce to gather client information and enhance service quality.
• Monitor resolution timelines to ensure benefit issues and claims are closed within the designated timeframe.
• Review Summary Plan Descriptions (SPDs) and benefit summaries for accuracy.
• Offer expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions to clients.
• Act as a primary resource within the team, delivering exceptional customer service and support in resolving insurance and benefit-related issues.
• Address member eligibility inquiries, enrollment entry and confirmation of coverage.

Skills

Communication

Organization

Problem-solving

Initiative

Team player

Detail-oriented

Microsoft Office

Spanish (bonus)

Tools

Salesforce

Microsoft Office

Job description

Corporate Synergies is seeking an Employee Benefits Customer Service Representative to handle claims resolution, benefits inquiries, and coverage eligibility for clients’ administrators and employees. You will work with clients and carriers via phone and email to resolve matters within a 24-hour timeframe.

Responsibilities include educating employees on benefit utilization, maintaining records in Salesforce, and reviewing SPDs for accuracy while delivering exceptional customer service.