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Benefits Specialist


TX - Houston

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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.

Major Responsibilities:

  • Function 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.
  • Function as a client resource for administrative questions regarding enrollment and eligibility and special contract provisions.
  • Aid 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 twenty-four 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.
  • Elevated 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 workload.
  • 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.

Job ID:


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