Employer Service Rep - LHB

About the Role

The day-to-day responsibilities of this role will involve working closely with external customers to resolve claim and customer service issues, conducting research and analysis to identify root causes, and developing recommendations for process improvements. You will also be expected to communicate effectively with clients, brokers, and internal stakeholders, providing timely updates and explanations on issue resolution.

The team context for this role is fast-paced and customer-centric, with a focus on delivering high-quality service and support to Tribal customers. As an Employer Service Rep, you will be part of a talented team of professionals who are passionate about making a positive impact on the lives of customers.

What You Will Do

• Research and resolve claim issues initiated by clients or brokers
• Provide timely written or verbal status updates and explanations to clients, brokers, or Client Management regarding issues
• Follow up regularly on outstanding issues to ensure timely resolution and client satisfaction
• Appropriately notify, refer, or escalate issues
• Track issues and document resolution
• Provide issue reports to Claims & Customer Management and Client Management on a regular basis
• Develop and maintain good relationships with select clients, Client Management, and Claims & Customer Service personnel
• Assist with benefit fairs or benefit meetings
• Complete special client requests or projects as directed
• Other duties as needed or assigned

What We Are Looking For

• High School diploma or GED equivalent
• Minimum five or more years of claim processing or health insurance industry experience
• Ability to work in a fast-paced, customer service-driven environment
• Excellent verbal and written communication skills
• Ability to research various topics, succinctly summarize findings, and develop recommendations
• Ability to work effectively with employees, members, providers, clients, and differing levels of co-workers
• Solid understanding of ERISA and DOL regulations
• Ability to read, analyze, and interpret documents and Summary Plan Descriptions (SPDs)
• Flexible and open to continued process improvement
• Self-directed individual who works well with minimal supervision
• Good leadership, organizational, and interpersonal skills
• Demonstrated critical thinking skills
• Ability to effectively deal with problems in varying situations and reach resolution
• Ability to learn new or proprietary systems, adapt to various system platforms, and effectively use MS Excel/Word

Nice to Have

• Bachelor's degree
• Good presentation skills
• Experience presenting and explaining benefits to a group or one-on-one

Benefits and Perks

• Competitive salary
• Comprehensive health insurance
• Retirement savings plan
• Paid time off and holidays
• Remote work stipend
• Opportunities for professional growth and development
• Access to cutting-edge technology and tools
• Collaborative and dynamic work environment

• Make sure to highlight your Excel skills and experience working with similar software tools in your application.
• Showcase your ability to work in a fast-paced environment and provide excellent customer service.
• Be prepared to discuss your experience working with Tribal customers and your understanding of their unique needs.
• Develop a strong portfolio that demonstrates your critical thinking and problem-solving skills.
• Research the company culture and values to understand how you can contribute to the team's success.
• Prepare to ask questions during the interview about the company's approach to customer service and how the role contributes to the organization's goals.