Benefits Associate

LanguageLine Solutions

About The Position

The Benefits Associate interfaces with internal and external resources to guide members through benefit plan options, costs, and detailed benefit reviews. The role responds to incoming calls and cases, follows up on issues that cannot be resolved during the initial contact, and assists members with open enrollment, new-hire elections, and changes in status. The position pays $17.71 per hour. The associate provides objective information about a range of benefits and health coverage options, helps members compare plans, researches and resolves benefit issues, and documents work in appropriate systems. The role requires strong customer service, careful adherence to company policies and applicable laws, and strict confidentiality of member information. The work is primarily sedentary in an indoor office environment, with continuous use of computers and telephones.

Requirements

High school degree or GED required.
At least one year of customer service, healthcare, or employee benefits experience required.
Basic knowledge of Microsoft Word and Excel required.
Must achieve an acceptable score on job-related testing and pass a standardized interview.
Strong communication skills and phone etiquette.
Ability to explain complex issues to members.
Effective listening skills.
Strong problem-solving and issue-resolution skills.
Excellent customer service and customer-resolution skills.
Strong organizational and administrative skills.
Ability to work in a team environment.

Nice To Haves

Associate’s degree from an accredited college or university in business administration, liberal arts, public health, healthcare management, or a related field.
Time spent pursuing a bachelor’s degree, such as junior or senior year, may be substituted for experience requirements.
Depending on assignment, bilingual ability in English, Spanish, or another language may be needed.
Knowledge of COBRA.
Knowledge of Medicare A and B, Medigap and supplement plans, Medicare Advantage, and Medicare Part D.
Knowledge of high-deductible health plans, including HRAs and HSAs.
Knowledge of FSAs, including limited FSAs.
Knowledge of coordination of benefits and determining the primary plan in simple cases.
Knowledge of Summary Plan Documents and Certificates of Coverage.
Knowledge of government programs, resources, legislation, and mandates, including the Affordable Care Act, FMLA, Medicaid, and CHIP.
Knowledge of fully insured and self-insured group health plans.
Knowledge of pharmacy benefits, including injectable medications.
Knowledge of individual health plans and Marketplace or exchange plans.

Responsibilities

Guide members on benefit plan options, costs, and detailed benefit reviews while following department and corporate policies.
Answer incoming member calls and cases assigned by a supervisor, and make outbound contacts when issues cannot be resolved initially.
Provide objective guidance on open enrollment, new-hire elections, and changes of status, including comparing benefit options.
Build rapport with members by phone and help them navigate benefit choices.
Answer questions about medical, dental, pharmacy, vision, life, short- and long-term disability, consumer-driven health plans, FSAs, provider selection, qualifying life events, and estimated costs of care.
Review plan options and costs for individual health insurance, Marketplace or exchange plans, COBRA, and Medicare plans.
Process calls in accordance with established policies, procedures, quality standards, and applicable laws and regulations.
Research benefit issues, follow them through to resolution, and document them thoroughly in department files and appropriate systems.
Prioritize work and monitor task status to provide timely, quality service.
Monitor issue trends and escalate trends to a supervisor for appropriate action.
Maintain confidentiality of customer information and data accessed in assigned systems.
Maintain professional relationships with internal and external customers, team members, and department contacts.
Cooperate with team members, provide quality service, treat others with dignity and respect, and escalate situations outside the employee’s control.
Perform other duties as assigned.