Insurance & Benefits Support Specialist

BRMS; Folsom (CA); On-site; USD 25,000 - 33,000; Full time

Job summary

Paylocity in California is seeking a Customer Support Representative (CSR) to deliver high-quality service in a busy on-site call center, handling member inquiries and resolving issues with empathy. The CSR will answer calls, guide clients through benefits questions, quote information, and maintain HIPAA compliance while logging details in the system.

The role requires strong communication and problem-solving skills and a stable attendance record.

Qualifications

• Inbound call center experience or medical/insurance background.
• Ability to read, write, and speak English effectively.
• Proficiency in MS Office.
• Excellent written and verbal communication.

Responsibilities

• Answer calls with proper greeting.
• Clarify client issues and provide resolutions.
• Explain information in layman's terms.
• Maintain confidentiality per HIPAA.
• Work on site with schedule 9:30 am -6:00 pm M-F.
• Document details in the system during calls.
• Provide empathetic customer service to de-escalate upset callers.

Skills

Customer service

Communication skills

Call center experience

Microsoft Office

HIPAA compliance

Problem solving

Education

4-year degree

Tools

Microsoft Office Suite

Job description

Description

Summary: The Customer Support Representative (CSR) provides a high level of customer service in a call center environment. As the first point of contact for our members, the CSR provides effective problem resolution by combining technical knowledge with unsurpassed relational skills in order to “delightfully satisfy” our customers.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Works on site with consistent attendance, schedule is 9:30 am -6:00 pm M-F.
• Answers telephone calls using the proper greeting.
• Listens to client’s issues and clarifies the question or problem the client needs to find a resolution.
• Provides information necessary to resolve client’s inquiry or problem.
• Explains information in layman’s terms so that the client understands the information.
• Demonstrates a high degree of empathy and applies customer service techniques to de-escalate situations where the caller is extremely upset.
• Processes routine insurance changes such as adding dependent(s) or spouse, changing a doctor, and change of address.
• Researches appropriate documents such as Summary Plan Documents to quote benefit correctly.
• Researches information regarding claims.
• Logs all details into the system using proper notation during the call.
• Maintains a high degree of confidentiality and conforms to all applicable HIPAA provisions.
• Maintains excellent attendance and punctuality and adheres to schedule.

Supervisory Responsibilities: This job has no supervisory responsibilities.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit for extended periods in front of a computer. The employee is frequently required to reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and use hands to finger, handle, or feel. The employee may frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. This position requires the employee to work in the office.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Requirements

Knowledge, Skills, & Abilities:

• Ability to provide effective leadership in all aspects of position.
• Excellent written and verbal communication skills.
• Must be dependable and maintain excellent attendance and punctuality
• Strong analytical skills and problem-solving skills.
• Subject-matter expert within field.
• Ability to keep up with changes in information to Plan documents in order to quote benefits correctly.
• Ability to grow with changing demands of the position and the company.
• Proficient computer skills in Microsoft Office Suite
• Call center experience in a medical/benefits environment highly preferred.
• Medical/Benefits Experience highly preferred.
• UR/Claims/COBRA/FSA/Eligibility Experience preferred.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: Must have Inbound Call Center experience or Medical and/or Insurance experience or a 4 year degree.

Language Skills: Ability to read, speak, and write effectively in English. Ability to interpret documents such as safety rules, memos, letters, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers or employees of organization. Ability to effectively address or resolve customer service issues within guidelines of the position.

Mathematical Skills: Ability to add and subtract, multiply and divide with 10's and 100's.

Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Certificates, Licenses, Registrations: n/a