Employee Benefit Claims Specialist
1 month ago
We are seeking a highly skilled and detail-oriented Employee Benefit Claims Specialist to join our team at Innovative Benefit Planning. As a key member of our team, you will play a vital role in ensuring a positive experience for our clients' members.
Job Summary:The Employee Benefit Claims Specialist will be responsible for providing exceptional client service by resolving member inquiries, claims, and issues related to benefits plans. This includes providing benefits plan advice, answering questions, and assisting with ID card requests, provider directories, member appeals, pre-authorization assistance, and referral assistance.
Key Responsibilities:- Respond to member inquiries and resolve claims and issues in a timely and professional manner.
- Provide benefits plan advice and answer questions related to member coverage.
- Assist with ID card requests, provider directories, and member appeals.
- Pursue each inquiry/claim until the most positive resolution is achieved and regularly communicate progress to the member.
- Escalate and communicate critical or complex inquiries to the Account Manager and other related service team members.
- Support members with provider research and provider issues.
- Provide member portal and benefit administration assistance.
- Coordinate with providers and carriers to ensure accurate billing and resolve discrepancies.
- Resolve member balance billing issues and negotiate provider bills as needed.
- Assist with members navigating alternative medical programs and carve-out solutions.
- Attend Open Enrollment meetings and complete employee benefits online enrollments into requisite carrier systems.
- Perform other duties as assigned.
- Bachelor's Degree or the recognized equivalent in experience.
- 1-3 years' client service experience.
- General knowledge of Group Benefit Programs.
- Ability to obtain Life and Health License within the first 60 days of employment.
We offer a hybrid work environment, competitive benefits, and a vibrant workplace designed for your success. Enjoy a culture that values your growth and supports your career aspirations. Join a team that celebrates diversity and is committed to creating an inclusive environment for all employees.
Apply now to take the first step in your career journey with Innovative Benefit Planning.
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