Employee Benefits Advocate

Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Customer Service Advocate to their Corporate Synergies team in Philly Metro Region. 

Job Summary:

The Benefits VIP Representative attends to claims resolution issues, benefits questions, eligibility of coverage concerns, etc. for the administrators and employees of our clients. They collaborate over the phone with clients and carriers to arrive at resolutions within a 24 hour time frame.   

Essential Functions:

• Resolve client employee insurance issues, handle questions regarding benefits and assists in claims processing issues. Also assists with patient advocacy and pre-certifications.  
• Educate client employees on proper benefit utilization and guidance on most cost effective plan usage.  
• Develops and updates all applicable required documents for plan provisions, administrative events, interface documentation and delivery channel documentation for clients in ongoing delivery.  
• Records and tracks all interaction with clients by keeping detailed notes, entering the data into Sales Force and running client analysis reports as needed.
• Utilizes Benefit Point to look up information on clients to better service their needs.  
• Tracks time to close and keeps within the allotted time frame in regards to benefit issues and/or claims resolution. 
• Reviews Summary Plan Descriptions(SPD’s) and benefit summaries for accuracy.
• Provides subject matter expertise on insurance billing and coding, employee group benefits, insurance procedures and plan descriptions to client.
• Serves as a primary resource within a team to the client while providing excellent customer service and management in resolving insurance/benefit issues.  

Competencies & Qualifications: 

• Strong verbal and written communication skills.
• Excellent multi-tasking and organizational skills.
• Ability to take initiative, prioritize work load, and meet tight deadlines.
• Excellent phone mannerisms.   
• Problem solver.   
• Above average follow through and persistence required to be successful.   
• Ability to converse, read, and write in Spanish is a plus.   
• Team player.
• Flexible and conscientious
• Strong knowledge of Microsoft Office Products

Education & Experience:

• Bachelor’s degree in Business, Insurance, or a related field is preferred.   
• Three plus years’ experience working in customer service/call center environment   
• Experience with an insurance industry carrier, broker, or insurance related vendor.   
• Knowledge of eligibility claims, medical coding and billing, etc.   
• Intermediate knowledge of benefit summaries and Benefit Plan Descriptions.   

Last updated on Aug 7, 2024