Internal Title: Employee Service Representative

Department: Employee Service Team

FLSA Status: Exempt

Reports to: Director of ESR

Employment Type: Regular, Full-Time, Onsite for learning period. Hybrid (2 days/week telework) following learning period.

Job Summary

In the words of our President, we are “characters through and through” and that is what sets us apart. We value collaboration, teamwork, inclusivity, and diversity. We believe in superior service, tailored solutions, and a culture of caring. A successful Employee Service Representative will maintain this mindset and integrate these values into their work. Our standards are high, and we hope yours are, too!

The right person for this position will enjoy customer service-oriented work and knows that strong relationships and open communication yield great results. It is a must for this person to enjoy problem solving, be flexible, have an eye for detail and value a high level of service. The Employee Service Representative (ESR) is responsible for providing exceptional service in response to questions or concerns related to employee benefits by our clients, their employees and/or covered family members. Resolution to these inquiries may require the Employee Service Representative (ESR) to research or escalate appropriately with insurance carriers, healthcare providers and/or internal team members.

The lines of coverage for this position will be: Medical, Dental, Vision, Spending Accounts, Life, AD&D, STD, LTD and other ancillary lines of coverage.

Job Responsibilities

• Answer and document inbound calls, emails or transactions.
• Make outbound calls as necessary to follow up on client issues to resolution.
• Resolve client issues or concerns regarding benefits, including group medical, Dental, Vision, Spending Accounts, Life, AD&D, STD, LTD and other ancillary lines of coverage.
• Assist in determining Coordination of Benefits policies as it applies to clients with dual-coverage and employees or their dependents
• Work with benefit plan providers in plan administration and problem resolution by reviewing claim policies and medical policies.
• Maintain internal database and updates to reflect the service provided to the caller.
• Assist with billing appeals and prior authorizations.
• Clearly and concisely explain benefit offerings, copays, deductibles, and co-insurance and how they interface with FSA, HSA and HRAs, including how they coordinate with other insurance.
• Explain how group benefits are initiated with waiting periods and terminated with explanation of COBRA

Job Skills and Qualifications

• 2 years of experience in healthcare field (insurance carrier or medical provider) or benefits administration
• 2 years of experience in a customer service position or call center position.
• Computer proficiency in MS Teams, Excel, Word, and PowerPoint ability to navigate phone system.
• Organized with the ability to manage multiple tasks simultaneously.
• Ability to manage competing priorities.
• Detail-oriented
• Customer/Client focused, with the ability to remain calm in urgent situations.
• Good verbal and written communication skills
• Consistently represent Creative Benefits, Inc. in a professional manner
• Bilingual with the ability to speak English and Spanish fluently is preferred.

Nice to Have Job Skills and Qualifications

• Prior knowledge of employee benefits and how they are administered under all various carriers, in accordance with Federal and State laws.

Supervisory Responsibility

This position is an individual contributor and not responsible for the leadership of other employees.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as office phones, laptop computers and photocopiers.

Physical Demands

While performing the duties of this job, the employee is regularly required to talk or hear. Specific vision abilities required by this job include close vision and ability to adjust focus. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.

Position Type/Expected Hours of Work

This is a full-time position. The service team hours of operation are Monday through Friday, 7:30 a.m. to 6 p.m. Main shift hours would be 8:30 to 5 pm but after training, would also work one 9:30 to 6 pm shift per week. If there is a preference for a 7:30 to 4 pm shift once per week, that can be arranged.

Travel

There is no required or expected travel for this position.

Creative Benefits, Inc. is an employee benefits consulting and brokerage firm with offices in Newtown Square and Kingston, Pennsylvania. We support small, mid-sized and large employers in the tri-state area and across the country in a variety of industries. It is our mission to create optimal solutions in employee benefits that 'insures' the right coverage for every stage of life.

Job Type: Full-time

Pay: From $40,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Referral program
• Vision insurance

Experience level:

• 1 year
• 2 years
• 3 years
• 4 years
• 5 years

Shift:

• Day shift

Weekly day range:

• Monday to Friday

Work setting:

• Hybrid work
• Office

Language:

• English and Spanish? (Required)

Work Location: Hybrid remote in Newtown Square, PA 19073