General Description: The Benefit Specialist's primary job is to help clients and their employees with benefit or claim questions and to log all calls for tracking and reporting purposes.
- Act as primary resource for clients and their employees with benefit or claim questions.
- Investigate and solve claim problems.
- Log all calls into Call Center database for tracking and reporting purposes (100% call tracking).
- Take requests from Account Managers for supplies and forward to the appropriate account administrator.
- Act as a client resource for administrative questions regarding enrollment and eligibility and special contract provisions.
- Provide assistance with coordination of benefits.
- Drafts appeal letters.
- Performs claim audits.
- Track trends to identify consistent claim and/or benefit question patterns from clients.
- Report trends to carrier and/or the account manager.
- Run reports for assigned producer team when requested.
- Maintain open call volume.
Training and Development:
- On-site ongoing training provided for all above duties.
- Off-site training as required for continuing education requirements.
Core Job Objectives:
- Establish effective working relationships with Internal Partners, Clients and Carriers
- Ensure client satisfaction and to support key initiatives.
- Work with Internal Partners and Carriers to ensure accurate and timely responses to all client issues.
- Work with all partners in a manner that fosters mutual respect and teamwork.
- Respond to requests from all partners by stated timeframes.
- Consistently be on time for work and all scheduled meetings and training classes.
- Respond to BRC emails and voicemails, when assigned, within 24 business hours.
Key Skills Required:
- Remains informed regarding industry information and new product information.
- Must currently hold life and disability insurance license (or must obtain it within 12 months following date of employment) and retain license by meeting the continuing education requirements.
- High level of computer literacy including working knowledge of Windows 2003, Excel, Word and call tracking systems.
- Bilingual preferred.
- Strong attention to detail and ability to self-check work.
- Excellent time management skills, keeps manager informed of problems.
- Organized and able to prioritize work load.
- Enthusiastic attitude, cooperative team player, adaptable to new or changing circumstances, professional demeanor, sensitive to client needs, self-motivated, creative and innovative.
- Excellent problem solving skills.
- Strong verbal and written communication skills.
- Prior customer service experience is preferred.
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100 Summit Lake Drive, Suite 400, Valhalla, NY 10595