Bilingual Claims Account Specialist

Diversified Benefit Services•Hartland, WI

2d•Hybrid

About The Position

We’re looking for a Bilingual Claims Account Specialist to join our Employee Benefits team and play an important role in helping employees navigate their benefits and claims. This position is ideal for someone who enjoys problem-solving, working with people, and bringing clarity to situations that can sometimes feel complicated or frustrating. This is a high-volume, fast-paced role where attention to detail, organization, and the ability to manage multiple priorities are essential and includes validation of claims and process reimbursements, status changes, enrollments, responding to client and participant inquiries and implementation of plan set-ups/changes. If you enjoy solving problems, working with people, and keeping the details moving behind the scenes, this could be a great fit. Spanish/English bilingual proficiency is required.

Requirements

Proven ability to provide a high level of customer service.
Possess excellent organizational, detail orientation, follow-through, analytical and problem-solving skills.
Possess basic math/accounting competencies required within position.
Effective multi-tasking skills.
Excellent interpersonal skills and demonstrated professionalism.
Ability to quickly change gears and demonstrate flexibility.
Solid working knowledge of Microsoft Office 365 (including excel).
Able to effectively work with personnel of varied skill levels and work through challenging situations efficiently.
Able to handle information confidentially.
Minimum of two years of experience in a professional work environment working directly with customers.
Spanish/English bilingual proficiency is required.

Nice To Haves

Experience administering FSA, HSA, HRA, ICHRA or other pre-tax benefit plans .
Previous experience with benefits administration or claims validation and process reimbursements.
Familiarity with employee benefits terminology and processes.
Experience working with insurance carriers, third-party administrators, employers, or benefit providers.
Experience supporting a high volume of clients, customers, or participants.
Previous experience working in a bilingual customer-facing role.

Responsibilities

Provide a high level of professional service to DBS clients and benefit plan participants
Responsible for day-to-day plan administration of pre-tax employee benefit plans for assigned group of clients that includes validation of claims and process reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software and implementing plan changes.
Effective regular communication in both English and Spanish with clients and plan participants via phone and email regarding plan changes, claims processing, updates, questions, etc.
Master various PC applications and learn software programs quickly.
Maintain current working knowledge of benefit plan designs and IRS regulations regarding plans.
Accurately enter and audit participant claims and determine eligibility for reimbursement.
Generate reports and audit accuracy of information.
Provide assistance to Customer Service Team during peak times when we experience increased claims and call volume.
Assist with basic office coverage for team members who are out of the office.
Work directly with all company departments to ensure client requests are met and a high level of service is consistently provided.