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.
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.