Remote job
Employer Service Rep - LHB
Job details
About this role
Role overview Resolve claim and customer service issues raised by clients or their representatives, coordinating with client management and operations to research what happened and reach a clear resolution. The role also tracks recurring issues and recommends process or procedure changes to help prevent them. This position can be performed remotely from the continental United States, except California, New York, Alaska, and Hawaii.
Responsibilities - Investigate claim and service concerns and explain findings to clients and internal partners. - Coordinate issue resolution with clients, operations teams, and client managers. - Track and monitor open issues through resolution. - Identify recurring problems and recommend improvements to processes and procedures. - Interpret plan documents, including Summary Plan Descriptions, when assessing issues.
Requirements - High school diploma or GED. - At least five years of experience in claim processing or the health insurance industry. - Working knowledge of ERISA and Department of Labor regulations. - Strong written and verbal communication, research, critical thinking, and problem-solving skills. - Ability to summarize findings and develop practical recommendations. - Comfortable working with members, providers, clients, and colleagues at different levels, often in a fast-paced service environment. - Able to work independently, adapt to changing processes and systems, and use Microsoft Excel and Word.
Nice to have - Bachelor’s degree. - Experience presenting or explaining benefits to individuals or groups. - Strong presentation skills.
Benefits and work setup The role includes an annual incentive plan and a stated salary range of $42,200–$79,300, with the specific offer depending on skills, experience, education, and location. The benefits package includes health and wellness coverage, retirement savings and pension plans, paid time off and holidays, paid parental leave, disability and life insurance options, employee assistance, and tuition reimbursement.