Employer Service Rep - LHB

This role supports Tribal ESR operations, providing claim and customer service issue resolution for a highly visible Tribal customer group. The position involves research, resolution, communication, and process improvement to ensure client satisfaction.

Location: Remote (US, excluding California, New York, Alaska, and Hawaii)

Salary: $42,200–$79,300/yr

Responsibilities

• Research and resolve claim issues initiated by clients and/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. May also provide periodic reports to clients.
• Recommend process, procedure or other actions to eliminate reoccurrence of issues or prevent future issues.
• 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/assigned.

Requirements

• Tribal experience required.
• High School diploma or GED equivalent.
• Minimum five or more years claim processing/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 a recommendation.
• Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff.
• Solid understanding of ERISA and DOL regulations.
• Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs).
• Flexible; 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/proprietary systems, to adapt to various system platforms, and to effectively use MS Excel/Word.

Benefits

• Meaningful benefits to support life outside of work, including health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives.

Additional Information

• The role offers a pay range of $42,200 to $79,300 annually, with compensation varying based on skills, experience, and location.
• The position is posted on Himalayas.