Benefits Specialist

LanguageLine Solutions

1d • Remote

About The Position

Health Advocate is seeking a Benefits Specialist to join their team. This role is responsible for interfacing with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review. The Benefits Specialist will answer incoming calls, respond to benefit inquiries, and place outbound follow-up calls for issues that cannot be resolved during the initial call. They will also provide guidance to members on open enrollment issues, questions, and concerns about benefit options, which may include comparing and contrasting benefits during open enrollment, for new hires, and during a change of status. The company emphasizes a supportive and friendly work environment with opportunities for growth, as many supervisors are promoted from within. Health Advocate is recognized for its customer service excellence and has received numerous awards.

Requirements

• High School Degree or GED required.
• Minimum of one to two years customer service.
• Minimum of one to two years benefits experience.
• Minimum of one to two years hands-on Medicare knowledge, including Medicare Advantage, Part A/B/D, and supplement plans.
• Basic knowledge of MS Word and Excel required.
• Must score acceptably on job related testing.
• Ability to pass standardized interview.
• Strong communication skills and phone etiquette.
• Ability to explain complex issues to members.
• Highly effective listening skills.
• Strong problems solving/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 with major course work in business administration, liberal arts, public health, healthcare management, or a related field preferred.
• Based on assignment may need to be bilingual in English, Spanish, etc.
• Knowledge of COBRA.
• Knowledge of Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans.
• Knowledge of High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs).
• Knowledge of Flex Spending Accounts (FSA), including limited FSAs.
• Knowledge of coordination of benefits and which plan is primary – simple cases (commercial plans, Medicare plans).
• Knowledge of Summary Plan Documents (SPDs) and Certificates of Coverage (COCs).
• Knowledge of Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP.
• Knowledge of Group Health Plans (fully insured and self-insured).
• Knowledge of Pharmacy benefits including injectable medications.
• Knowledge of Individual Health Plans and Marketplace/Exchanges plans.

Responsibilities

• Interface with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review ensuring adherence to department and corporate policies and procedures.
• Answer incoming calls/cases and respond to member benefit inquiries, cases and calls assigned by supervisor and place outbound calls and/or contacts to members for calls and cases that cannot be resolved during the initial call.
• Provide objective information to members on open enrollment issues, questions, and concerns about benefit options, which may include comparing and contrasting benefits during open enrollment, new hire election period and change of status.
• Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options.
• Answer members’ questions related to benefit plans (i.e., medical, dental, pharmacy, vision, life, STD, LTD, and other benefits) consumer driven health plans, FSAs, provider selection, qualifying life events, open enrollment, and estimated cost of care.
• Review plan options and costs for members considering individual health insurance plans, Marketplace/exchange plans, COBRA, and Medicare plans.
• Exercise exceptional customer service skills to optimize each contact with the member.
• Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations.
• Follow policies and procedures to remain in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Affordable Care Act, and other legislation.
• Resolve benefit issues by identifying issue(s) and researching in a timely manner ensuring adherence to department and corporate policies and procedures.
• Follow research through until resolution is reached for member.
• Document all benefit issues thoroughly, maintaining department files and appropriate systems.
• Continuously evaluate the status of all work efforts, ensuring all tasks are prioritized to assist in providing timely and quality services.
• Assist in monitoring issue trends, escalating such trends to supervisor to determine appropriate actions necessary to eliminate future occurrences and improve service levels.
• Maintain strict confidentiality of information provided by customer or data accessed within assigned systems.
• Establish and maintain a professional relationship with internal/external customers, team members and department contacts.
• Cooperate with team members to meet goals or to complete tasks.
• Provide quality customer service that exceeds customer expectations and improves level of service being provided.
• Treat all internal/external customers, team members, and department contacts with dignity/respect.
• Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided.

Benefits

• Comprehensive Training & Equipment
• Career Growth & Development
• Competitive Pay & Benefits
• Robust medical, dental, vision, tuition assistance, a 401(k) with company match, PTO, and paid holidays.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED