JOB SUMMARY:

The role of the Client Care Specialist (CCS) is to address all employer health benefit issues as brought up by employee Benefits (EB) clients, including resolving enrollment and termination issues, claims and appeals, acting as liaison with our insurance advocacy partners at Alight (Health Pros), insurance carriers and third party administrators, works with insurance carriers and TPA’s to resolve billing inquiries, reading and interpreting insurance contract language and regulations. CCS regularly practices discretionary decision making on a daily basis.

KEY RESPONSIBILITIES:

Essential Duties & Responsibilities:

»        Works directly with clients to answer questions and resolve their issues, and loads activities into CRM Database (Epic)

o    Resolves enrollment and termination issues.

o    Answers questions relating to legislation and benefit laws regarding HIPAA, COBRA, and FMLA.

»        Updates internal systems such as Epic upon group renewal

»        Introduces their role to all new key contacts to build solid relationships and meets existing contacts as needed to further enhance relationship.

»        Maintains a full book of business while continuing to provide A+ service.

»        Utilizes MS Outlook, Excel, Word and other Microsoft Applications

»        Follows EBS internal color-coded outlook organization standard operating procedures.

»        Follows internal call back standard operating procedures and email response time

TALENTS/STRENGTHS REQUIRED

»        Self-starter and quick learner

»        Excellent problem-solving skills. Persistent to achieve the end result—resolution.

»        Strong organizational skills, including daily prioritizing and logical thinking.

»        Service-oriented; kind, compassionate, and willing to work hard on another person’s behalf.

»        Good communication skills, written, verbally and over the phone. Clarity and accuracy are key attributes.

»        Excellent phone skills, responsiveness, empathetic, and honesty with the information to be shared.

»        Strong working knowledge of computers (MS Word, MS Outlook preferred; Internet, MS Excel and database experience are also beneficial) and able to learn new systems and programs, such as Sales Force.

»        Able to manage multiple projects simultaneously and successfully.

»        Able to work with others in teams; able to work with those who perform similar jobs as well as complimentary roles. Promotes cooperation and share successes throughout the company.

»        Shares ideas for improvement which are oriented around solutions and blameless problem solving.

CONTINUING EDUCATION

As a condition of employment, the Enrollment Specialist must:

»        Pass the Maryland State Life & Health exam within the first 90 days of employment.

»        Fulfill Maryland State Continuing Education (CE) requirements annually.

»        Participate in internal training sessions and other professional development opportunities as needed.

KNOWLEDGE/EXPERIENCE REQUIRED

»        Insurance experience preferred; at least 3 years of work experience (claims resolution, benefits administration, health insurance customer service, etc.).

»        College degree preferred

»        Knowledge of Microsoft Office with an emphasis on Outlook and Excel 

PHYSICAL REQUIREMENTS/MISCELLANEOUS

»        Valid Driver’s License.

»        There are no physical requirements for the position.