Benefits Specialist

USI Seattle , WA 98113

Posted 2 months ago

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:

  • 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.

Job ID:

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Benefits Specialist