Employer Service Representative

Location

United States

Posted

2 days ago

Salary

$50K - $55K / year

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

Employer Service Representative

Point C

• Serve as a primary contact for assigned employer groups regarding benefits administration and service inquiries • Respond to employer, broker, and member requests via phone, email, and ticketing systems within established service standards • Educate employer groups on TPA processes, policies, eligibility rules, and available services • Build and maintain positive working relationships with clients and brokers • Coordinate with claims, provider relations, and stop-loss departments to resolve escalated issues • Research claim status inquiries and facilitate timely resolutions • Track and document service issues to ensure follow-through and client satisfaction • Maintain confidentiality and ensure compliance with HIPAA and company policies • Document client interactions and account activity accurately within internal systems • Support audit requests and reporting needs as required • Participate in employer implementations and renewals • Identify opportunities for process improvement and enhanced client experience • Support special projects and cross-functional initiatives as assigned

Job Requirements

  • High school diploma or equivalent required; associate or bachelor's degree preferred
  • 2+ years of customer service or account management experience in healthcare, insurance, benefits administration, or TPA operations
  • Experience in a self-funded health plan or TPA environment preferred
  • Knowledge of ERISA, COBRA, HIPAA, and ACA requirements preferred
  • Experience working with brokers, employer groups, and carrier partners
  • Working knowledge of group health benefits, eligibility, claims processing, and billing practices
  • Proficiency in Microsoft Office Suite and ability to learn multiple administrative systems
  • Strong attention to detail and organizational skills
  • Clear and confident communication skills for both internal and external customers.

Benefits

  • Comprehensive medical, dental, vision, and life insurance coverage
  • 401(k) retirement plan with employer match
  • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
  • Paid time off (PTO) and disability leave
  • Employee Assistance Program (EAP)

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