Benefits Specialist
Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company. Join our award winning team!
2025:
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Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
2024:
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Excellence in Customer Service Awards: Organization of the Year (Small)
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Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner
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Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)
As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For®’ in the USA by Great Places to Work (GPTW®)
Basic Function
Responsible for interfacing with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors and detailed benefit review; answer incoming calls and respond to benefit inquires; place outbound follow-up calls for issues that cannot be resolved during the initial call; provide guidance to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status
Major Job Accountabilities
Benefits Functions – Interface with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review ensuring adherence to department and corporate policies and procedures.
- Answer incoming calls/cases and respond to member benefit inquires, cases and calls assigned by supervisor and place outbound calls and/or contacts to members for calls and cases that cannot be resolved during the initial call
- Provide objective information to members on open enrollment issues, questions, and concerns about benefit options, which may include comparing and contrasting benefits during open enrollment, new hire election period and change of status
- Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
- Answer members’ questions related to benefit plans (i.e., medical, dental, pharmacy, vision, life, STD, LTD, and other benefits) consumer driven health plans, FSAs, provider selection, qualifying life events, open enrollment, and estimated cost of care
- Review plan options and costs for members considering individual health insurance plans, Marketplace/exchange plans, COBRA, and Medicare plans
- Exercise exceptional customer service skills to optimize each contact with the member
- Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations
- Know and support approved departmental and corporate policies and procedures
- Follow policies and procedures to remain in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Affordable Care Act, and other legislation
- Resolve benefit issues by identifying issue(s) and researching in a timely manner ensuring adherence to department and corporate policies and procedures
- Follow research through until resolution is reached for member
- Document all benefit issues thoroughly, maintaining department files and appropriate systems
- Continuously evaluate the status of all work efforts, ensur