HR Benefits Specialist, Employee Support

2 weeks ago

Charleston, West Virginia, United States CommuniCare Family of Companies Full time
HR Benefits Specialist Job Description

We are seeking an HR Benefits Specialist to support employees in all matters related to insurance benefits. This role involves travel to various facilities and requires a valid driver's license.

Key Responsibilities:
  • Serve as onsite liaison for health plan education, questions, issues, and concerns.
  • Manage employee service requests and escalations with insurance.
  • Assist with claims issues using various teaching methods, including 1:1 meetings, lectures, group activities, case studies, and online learning modules.
  • Assemble and distribute benefit summaries, benefit guides, and enrollment guides.
  • Respond to and handle incoming electronic escalation submissions of insurance issues.
  • Assist employees with finding participating providers and expediting services/treatment.
  • Identify options and services to support employee independent healthcare decision-making.
  • Use a holistic approach to consult, mentor, and collaborate with onsite HR staff, Care Advocates, team members, supervisor, case managers, or other multidisciplinary team members to address employee needs efficiently and effectively.
  • Identify and escalate quality of care issues through established channels.
  • Serve as a point of contact for employee inquiries via phone, email, and in-person interactions.
  • Ensure strict compliance with HIPAA and maintain the highest standards of patient confidentiality and trust.
  • Maintain excellent record-keeping and documentation of issues, interventions, and resolutions.
  • Attend daily huddles and weekly staff meetings.
  • Create weekly reports for leadership and support with eligibility/enrollment.

This role requires a strong understanding of healthcare insurance industry, excellent communication and problem-solving skills, and the ability to work effectively in a team environment.

We offer a full, robust benefit package, 2 weeks of vacation, paid sick days, and holidays. Qualified candidates must have a car and a valid driver's license. We pay for mileage and expenses.

This is a mobile position based in Charleston, WV, and involves travel to all 41 of our West Virginia facilities, as well as pharmacy and home health offices.

Requirements:
  • Minimum of Associate's Degree, with a Bachelor's Degree in Human Resources or a related field preferred.
  • Minimum of 2 years of experience working for a healthcare insurance plan, with managed care experience preferred.
  • Proven experience and knowledge providing benefit advice to self-funded employee benefit plan members and conducting benefit educational meetings.

We are looking for a highly developed verbal and written communication skills, superior time management and organization skills, and the ability to work effectively in a team environment.

This role requires a strong research ability, initiative to improve patient quality of life, and a genuine desire to help others.

We pay for mileage and expenses, and require a reliable internet connection with continuous 50-100Mbps internet speed and a dedicated, private, quiet distraction-free area space for work only, meeting HIPAA standards.

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