Customer Service Advocate

Responsibilities

• Handle claims resolution, benefits inquiries, and coverage eligibility concerns
• Work closely with clients and carriers via phone and email to resolve matters within 24 hours
• Address client employee insurance concerns and assist with patient advocacy and pre-certifications
• Educate client employees on optimal benefit utilization and cost-effective plan options
• Maintain detailed records of client interactions in Salesforce
• Monitor resolution timelines to ensure claims are closed within designated timeframes
• Review Summary Plan Descriptions (SPDs) and benefit summaries for accuracy
• Address member eligibility inquiries, enrollment entry, and confirmation of coverage

Requirements

• Three plus years of experience in a customer service or call center environment
• Experience with an insurance industry carrier, broker, or related vendor
• Knowledge of eligibility claims, medical coding, and billing
• Knowledge of benefit summaries and Benefit Plan Descriptions
• Proficiency in Microsoft Office Suite
• Exceptional verbal and written communication abilities

Preferred Qualifications

• Proficiency in Spanish (both written and spoken)

Benefits

• Medical, vision, and dental insurance
• 401(k) with company match
• Company paid life insurance
• Short-term disability (STD) and Long-term disability (LTD)
• Generous PTO starting at 18 days per year
• 10 paid holidays and 2 floating holidays

About the Company

Foundation Risk Partners is one of the fastest growing insurance brokerage and consulting firms in the US.