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Employee Benefit Claims Specialist

5 months ago

Moorestown, United States Innovative Benefit Planning Full time
Join Our Team as an Employee Benefit Claims Specialist

About Us

Innovative Benefit Planning is a woman owned business that thrives on innovation and integrity, shaping employee benefits, wellness, HR Consulting, and group retirement planning nationwide. For 35 years, our commitment to putting people first has been at the heart of everything we do.

Your Impact Matters

In a smaller company, bureaucracy does not dilute your influence. Your insights will be heard, valued, and acted upon. You will not be just another cog in the machine - you will be a linchpin, an indispensable part of the team driving meaningful change and growth. Your ideas will be the catalyst for innovation, and your efforts will directly contribute to our success story.

Collaborative Environment

Collaboration is not just a buzzword here; it is the essence of how we operate. You will have the opportunity to collaborate closely with colleagues from various departments, fostering an environment where every voice is heard, and every opinion matters.

Professional Growth

Your professional development is not just a checkbox; it is a commitment. We are invested in your growth and provide you with opportunities to expand your skills and advance your career. Your success is our success, and we will work together to ensure you reach your full potential.

If you are ready to make a real impact, take ownership of your work, and be an integral part of a thriving company, your journey towards professional fulfillment starts here.

A day in the life as an Employee Benefit Claims Specialist:

As a full-time Employee Benefit Claims Specialist, you will play a pivotal role in ensuring a positive experience between Innovative and our clients' members.

Responsibilities include:

Client Member Support Duties:
  • Answer and respond to all issues, claims, and problems related to members or dependents coverage. These include benefits plan advice and questions, ID card requests, provider directories, member appeals, pre-authorization assistance, and referral assistance.
  • Diligently and quickly pursue each inquiry/claim until the most positive resolution is achieved; regularly communicate the progress to the member and document in the Innovative database.
  • Escalate and communicate critical or complex inquiries to the Account Manager and other related service team members to ensure the best possible resolution.
  • Provide support in selecting plans for members and their dependents.
  • Assist members with provider research and provider issues.
  • Support members with navigation of pricing transparency tools.
  • Provide member portal and benefit administration assistance.
  • Coordinate with the provider or carrier to ensure the bill is correct and assists with resolving discrepancies.
  • Resolve member balance billing issues.
  • Negotiate provider bills as needed.
  • Assist with members navigating the complexities of alternative medical programs and carve out solutions i.e., reference-based pricing.
  • Attend Open Enrollment meetings if necessary.
  • Complete employee benefits online enrollments into requisite carrier systems and process enrollment as ne
  • Performs all other duties assigned.
CORE COMPETENCIES:
  • Ability to identify client needs and provide solutions to address those needs.
  • A collaborator who can collaborate and build consensus.
  • A strong customer service focus
  • A sense of urgency and ownership in all you do
  • The ability to manage several different assignments and responsibilities at the same time.
  • Proficiency with Microsoft Office Suite
  • The ability to effectively interact and communicate with various insurance carriers, clients, and team members.
  • A willingness to continually upgrade their knowledge and understanding of the insurance industry and desire to advance within the organization.
Why Innovative?

Join a culture that values your growth and supports your career aspirations. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Life at Innovative:
  • We offer a hybrid work environment to ensure a positive work life balance.
  • Enjoy competitive benefits and a vibrant workplace designed for your success.
    • Medical, dental, vision, life, and disability plans
    • 401(k) plan with employer contributions
    • Life insurance and disability coverage
    • Legal Shield/ID Shield options
    • Tuition Reimbursement program
  • Competitive salary
  • Flexible PTO policy with 2 weeks of PTO for the first year and open PTO after your 1-year anniversary
  • Sixteen hours of paid Volunteer Time Off annually
Culture at Innovative:

We cultivate a team environment with special celebrations including:
  • Team building events.
  • Monthly employee recognition.
  • Endless snacks and freebies in the office cafe.
  • Commitment to workplace wellness programs and events.
About You:
  • Bachelor's Degree or the recognized equivalent in experience
  • 13 years' Client Service experience
  • A general knowledge of Group Benefit Programs
  • Must obtain Life and Health License within the first 60 days of employment.


Join us at Innovative Benefit Planning and make a meaningful impact on the lives of our clients and their employees. If you are a dedicated professional with a passion for client success and meet the qualifications outlined above, we invite you to apply here:

Innovative Benefit Planning is an equal opportunity employer.