Employee Benefits Insurance Admin

Employee Benefits Insurance Admin

This Benefits insurance administrator is responsible for providing quoting support and placement of insurance lines within the group insurance administrative team. They play a crucial role in ensuring smooth enrollment into programs elected and coordinate communication while maintaining accurate records. They must a be detail-oriented professional who thrives in a fast-paced environment and possesses excellent organizational and communication skills.

Tasks and Responsibilities –

1.            Client Consultation:

•Meet with clients to understand their health insurance needs, budget, and coverage preferences.

•Provide detailed information about different health insurance plans, including benefits, coverage limits, deductibles, and premiums.

•Explain various health insurance terms, such as copayments, coinsurance, out-of-pocket maximums, and network restrictions.

•Assist clients in completing applications and enrollment forms accurately and efficiently.

•Answer client questions and address concerns regarding health insurance options and eligibility.

2.            Plan Research and Analysis:

•Stay updated on the latest health insurance policies, regulations, and industry trends.

•Research and compare health insurance plans from different carriers to identify the most suitable options for clients.

•Analyze plan features, pricing structures, and provider networks to determine the best fit for clients' needs.

•Evaluate coverage options for specific health conditions, medications, or specialized services.

•Consider factors like affordability, comprehensiveness, and customer satisfaction ratings when recommending plans.

3.            Enrollment and Policy Management:

•Facilitate the enrollment process by submitting applications to insurance carriers on behalf of clients.

•Track and follow up on application progress to ensure timely processing and approval.

•Assist clients with understanding and utilizing their health insurance benefits effectively.

•Coordinate with insurance carriers and clients to resolve any enrollment or policy-related issues.

•Update client records and policy information accurately in company’s databases and systems.

4.            Customer Service and Support:

•Provide ongoing customer support to policyholders, including assistance with claims, billing inquiries, and coverage changes.

•Help clients navigate insurance portals, online tools, and mobile applications.

•Advocate for clients in resolving claim disputes or other issues with insurance carriers.

•Educate clients on health insurance regulations, rights, and responsibilities.

•Handle customer complaints or concerns professionally and escalate complex issues as needed.

5.            Relationship Building and Networking:

•Build and maintain relationships with insurance carriers, underwriters, and other industry professionals.

•Collaborate with insurance representatives to negotiate rates, resolve client issues, and explore new coverage options.

•Attend industry conferences, seminars, and networking events to stay updated and expand professional connections.

•Actively promote the company's services and build a positive reputation within the community.

Qualifications and Skills:

•High school diploma or equivalent; additional education in business, insurance, or a related field is a plus.

•Life and Health licensed agent a plus.

•Previous experience in the health insurance industry, preferably working for an insurance company or brokerage.

•In-depth knowledge of health insurance plans, terminology, and regulations.

•Familiarity with different insurance carriers and their product offerings.

•Strong customer service and communication skills.

•Excellent interpersonal and negotiation abilities.

•Detail-oriented and organized with the ability to manage multiple clients and deadlines.

•Proficient in using computer systems, insurance company or agency software, and online tools.

•Active insurance licenses or the ability to obtain them as required by state regulations.

Note: The job description provided above is a general outline of the typical responsibilities and qualifications for an Insurance Administrative role.