Experience. Solutions. Results.
Benefit Advocate
Location
United States
Posted
2 days ago
Salary
$14 - $28 / hour
Seniority
Junior
Job Description
Benefit Advocate
Luminare Health
• Managing and coordinating a high volume of service requests (phone, emails, portal, chat) from employees (and their immediate family) of our clients • Educating and assisting callers with understanding, navigating through and obtaining the maximum value of their healthcare and wellness benefits, and employee incentive programs provided by their employers • Assisting employees to understand their benefit plan offering, and providing direction in working through a variety of benefit issues
Job Requirements
- High School diploma or GED equivalent
- Minimum one year of insurance and/or benefits customer service experience
- Ability to effectively organize and prioritize work demands in a dynamic, fast-paced environment
- Ability to continuously display a positive attitude and follow directions
- Possess excellent customer service skills including proper grammar, tonalities and clear dictation
- Proficient in Microsoft Office Suite, data entry and electronic mail applications
- Excellent written and verbal communication skills, including the ability to adapt communication style to persons representing diverse personal, professional, cultural and socio-economic backgrounds
- Must be able to work a flexible 37.5 hour work week in a 24/7/365 call center environment – some 3rd shift, evenings, weekends, and holidays will be required
- Ability to sit and use the phone for long periods of time
Benefits
- Health and wellness benefits
- 401(k) savings plan
- Pension plan
- Paid time off
- Paid parental leave
- Disability insurance
- Supplemental life insurance
- Employee assistance program
- Paid holidays
- Tuition reimbursement
Related Guides
Related Categories
Related Job Pages
More Advocate Jobs
Benefit Advocate
Health Care Service CorporationEmpowering Whole Person Health With Compassion and Innovation
• Managing and coordinating a high volume of service requests (phone, emails, portal, chat) from employees (and their immediate family) of our clients • Educating and assisting callers with understanding, navigating through, and obtaining value of their healthcare and wellness benefits • Providing direction in working through a variety of benefit issues
• Lead the handling of complex and high-severity claims involving Directors & Officers (D&O) Liability, Employment Practices Liability (EPL), Fiduciary Liability, Crime/Fidelity, Professional Liability / Errors & Omissions (E&O), Cyber. • Review claim notices, demand letters, subpoenas, regulatory investigations, and lawsuits to identify potential insurance coverage. • Report new matters under all applicable policies and assist clients with preservation of insurance rights. • Develop and execute claim strategies designed to maximize policyholder recovery. • Coordinate and manage communications among clients, insurers, defense counsel, coverage counsel, forensic firms, and other claim stakeholders. • Monitor insurer investigations, coverage positions, and claim handling activities to ensure timely and fair claim resolution. • Negotiate coverage disputes, defense cost advancements, settlements, and allocation issues with insurers. • Analyze policy language, endorsements, exclusions, and program structures to identify coverage opportunities and potential gaps. • Provide technical coverage analysis and guidance regarding management liability, professional liability, and cyber insurance policies. • Support policy placement teams by identifying claim trends and recommending enhancements to policy language and program structure. • Serve as a primary claims contact for assigned clients and broker teams. • Build and maintain trusted relationships with risk managers, general counsel, executives, finance leaders, and other client stakeholders. • Conduct claim reviews, stewardship meetings, and claim trend analyses for clients. • Provide proactive updates regarding claim developments, emerging exposures, and market trends. • Support new business opportunities by participating in client presentations, RFP responses, and prospect meetings.
• Provide assistance to viewers via phone and/or chat regarding account management, billing queries, content questions, and basic navigation of our site and applications. • Make Disney Streaming product recommendations on each viewer interaction. • Other duties as assigned.
• Handle provider compensation inquiries through ticket-based workflows, contributing to SLA requirements and completing upwards of 600 tickets per week. • Research, investigate, and resolve provider compensation inquiries, including missed session payments, rate questions, bonus eligibility, and payment discrepancies. • Ensure all compensation decisions align with internal policies, documented guidelines, and program integrity standards. • Identify potential trends in compensation irregularities or bonus misuse and escalate when necessary. • Evaluate provider eligibility for onboarding incentives, state-based programs, and bonus structures based on established criteria. • Communicate bonus approval or denial decisions clearly and transparently. • Maintain up-to-date knowledge of evolving incentive guidelines and assist with documentation updates as needed.




