Employee Benefits Customer Service Representative

Corporate Synergies; Oregon; Hybrid; USD 30,000 - 34,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Company-paid life insurance

Short-term disability

Long-term disability

PTO and holidays

Job summary

Foundation Risk Partners in the United States is seeking an Employee Benefits Customer Service Representative to support clients' administrators and employees with claims, eligibility, and benefit inquiries. The role collaborates with carriers by phone and email to resolve matters promptly.

You will document interactions in Salesforce, review SPDs, and help educate clients on plan options. Proficiency in Spanish is a plus; three years in customer service and insurance familiarity preferred.

Qualifications

• Three plus years of experience in customer service/call center environment.
• Experience with an insurance industry carrier, broker, or insurance related vendor.
• Knowledge of eligibility claims and medical coding and billing.

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 analyses as needed.
• Use Salesforce to gather client information and improve service quality.
• Monitor timelines to ensure benefit issues are resolved within 24 hours.
• Review SPDs and benefit summaries for accuracy.
• Provide expertise on insurance billing, group benefits, and plan descriptions to clients.
• Serve as a primary resource in the team delivering high-quality customer service.

Skills

Verbal communication

Written communication

Organizational skills

Multi-tasking

Problem solving

Initiative & prioritization

Spanish (bonus)

Team player

Detail-oriented

Microsoft Office

Tools

Salesforce

Microsoft Office

Job description

Foundation Risk Partners

Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firms in the US, is adding an Employee Benefits Customer Service Representative to their Corporate Synergies team.

Job Summary

The Employee Benefits Customer Service Representative handles claims resolution, benefits inquiries, coverage eligibility concerns, and other related issues for our clients' administrators and employees. They work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe.

Essential Functions

• Address 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.

Competencies & Qualifications

• Exceptional verbal and written communication abilities.
• Outstanding organizational and multi-tasking capabilities.
• Strong problem-solving skills.
• Skilled at taking initiative, prioritizing tasks, and meeting tight deadlines.
• Proficiency in Spanish (both written and spoken) is a plus.
• Collaborative team member.
• Adaptable and detail-oriented.
• Proficient in Microsoft Office Suite.

Education & Experience

• Three plus years' experience working 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, etc.
• Knowledge of benefit summaries and Benefit Plan Descriptions.

Pay Transparency Range

$22—$25 USD

Benefits

• FRP offers a comprehensive range of health-related benefit options including medical, vision, and dental.
• We offer a 401(k) with company match.
• Company paid life insurance.
• STD.
• LTD.
• A generous PTO policy starting at 18 days per year plus 10 paid holidays & 2 floating holidays!

Equal Employment Opportunity (EEO)

FRP provides equal employment opportunity to qualified persons regardless of race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, veteran status, or any other classifications protected by law.