Benefits Representative Job Description
Benefits representative
provides support in compliance with all federal and state laws related to benefits offerings and reporting including: IRS, ERISA, COBRA, HIPAA, Section 125, ACA (1094 transmittals, PCORI, 5500 filings).
Benefits Representative Duties & Responsibilities
To write an effective benefits representative job description, begin by listing detailed duties, responsibilities and expectations. We have included benefits representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Responsible for administration of Health and Welfare benefits within applicable regulations (ERISA, Section 125, COBRA, HIPAA, FMLA, ADA, ACA, ) and company policies including managing enrollments, changes and terminations, employee and administration problem resolution, and payment of carrier premiums
Responsible for the sales of ADP's Major Medical insurance products to new and existing clients within a defined geographical territory
Process Evidence of Insurability (EOI) forms in accordance with documented customer procedures
Meet established quality goals by gathering and entering accurate data into the systems
Coordinate and administer health, dental, and life insurance plans
Review accuracy and maintains the human resources database
Prepare deductions and contributions for each payroll
Create reports regarding all administered benefits
Design and distribute materials for benefits orientations, open enrollment and summary plan descriptions
Serve as primary contact for plan vendors and third-party administrators
Benefits Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Benefits Representative
List any licenses or certifications required by the position: CHRS, CEBS, GBA, HR, HRCI, NCLE, ABO
Education for Benefits Representative
Typically a job would require a certain level of education.
Employers hiring for the benefits representative job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Collage Degree in Business, Education, Human Resources, Associates, Business/Administration, Communication, Finance, General Education, Public Administration, Accounting
Skills for Benefits Representative
Desired skills for benefits representative include:
Accesses and uses other expert resources when appropriate
Profession and industry
Is regarded as an expert in the technical/functional area
CPT coding and HCPS coding application
Basic benefits processes
COBRA and IRS Section 125
Laws pertaining to employee benefits
COBRA
Company processes and procedures to respond to incoming communication from insurance companies
Desired experience for benefits representative includes:
Provide training and support to group benefits associates, home office associates and the field staff
Investigate discrepancies and provides information in non-routine situations
Handle enrollments, terminations, changes, beneficiaries, disability, accident and death claims, rollovers, QDROs, distributions, loans, hardships and compliance testing
Oversee maintenance of employee benefits files and updating of employee payroll records
Gather employee data and oversee the processing of monthly billings and the preparation of vouchers for payment of administrative fees for all group plans
Allocate group health and dental claims monthly and reviews quarterly
Benefits Representative Examples
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Benefits Representative Job Description
Job Description Example
Our innovative and growing company is hiring for a benefits representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefits representative
- Develop communication tools to enhance understanding of the company's benefits package
- Handle benefit inquiries and complaints to ensure quick, equitable, courteous resolution
- Develop and conduct new employee orientation session for new hires to explain benefit packages available
- Prepare and develop communication and educational materials regarding the benefits package for all insured employees
- Manage Pension and Benefits policy queries via the case management system, phone and email within agreed SLAs
- Responsible for calculation, management and accurate entry of Pension and Benefits information onto the HRIS system, as required within set deadlines
- Responsible for reconciliation of Pension and Benefits scheme transactions through Payroll and Accounting
- Responsible for correspondence to employees, ex-employees, and pensioners as and when required
- Responsible for administration of the company benefits packages including but not limited to private health insurance, dental insurance, staff travel scheme and flu vaccinations
- Responsible for ensuring timely payment of Benefits payments to 3rd party providers
Qualifications for benefits representative
- Manage accurate and timely reporting, to internal stakeholders and external pension administrators
- Ensure Pension and Benefits processes and procedures are up-to-date and maintained at all times
- Instruct employees to the appropriate resource for benefit questions if able to
- Provide benefit eligibility and enrollment compliance information to all locations for perpetual and Open Enrollment periods
- Aid in the development and distribution of employee benefit Information
- Handle employee level claims issues on behalf of the employee with the respective carrier
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Benefits Representative Job Description
Job Description Example
Our growing company is hiring for a benefits representative. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for benefits representative
- Provides day-to-day benefits related research and information to faculty, staff and retirees requiring a knowledge of the university’s benefit plans, programs and policies, questions regarding how our health and welfare plans work, employee and dependent eligibility, and completion of enrollments
- Reviews and approves enrollment by faculty and staff in the Health & Welfare Plans online assuring the required documentation is received for elections made
- Responds to client inquiries and complaints to ensure timely and courteous resolution of problems related to benefits enrollment and processing
- Acts as a liaison with university employees and external benefits contacts
- Reviews and triages all assigned reports
- Research and investigate any issues between payroll, benefits and external vendors to assist employees with any heath benefit related questions in a timely manner
- Monitor waiting periods for benefit eligibility, initiate employee notification and distribute benefit material
- Monitor all area related conditions, property and equipment within corporate standards for cleanliness, proper maintenance and safety
- Cold calling brokers and agencies
- Provide technical assistance to employees, dependents and agencies to resolve benefits issues (e.g., health, ancillary benefits, dependent care programs)
Qualifications for benefits representative
- Researches complex telephone and written inquiries from active and former employees concerning eligibility, payments, policies and procedures
- Resolves plan related complaints and appeals by telephone and/or in writing
- Coordinates claim activities with third party administrator and/or Benefits Trust
- Utilizes existing queries & reports to analyze & research issues related to employee benefit plans
- Ensure proper follow-through on all directives, bulletins and schedules from the Corporate Office and Supervisor of U.S. Benefits
- Associates Degree with at least two years prior work experience in Human Resources, or combined equivalent of education and experience
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Benefits Representative Job Description
Job Description Example
Our growing company is hiring for a benefits representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefits representative
- Ability to build positive client relationships
- Educate Plan Administrators, Plan Members and Advisors on our E-Services capabilities
- Educate Plan Administrators and Advisors on our administrative practices, contractual terms and product offerings
- Understand client wants and needs and take appropriate action to meet them
- Answer questions from employees on benefit related matters, distribute forms to employees, new hire orientation
- Stays current on available financial aide
- Maintains updated manuals, logs, forms, and documentation
- Compose communications, using appropriate terminology, forms, templates, and software
- Responds to confidential inquiries and develops responses for Human Resource Business Partners with regard to the provisions of the plans and their application in each individual’s circumstances
- Assists in the administration of all policies and procedures relating to the medical, dental, prescription drug, vision, life, long-term disability, long-term care, EAP, FSA, and retirement and savings plans
Qualifications for benefits representative
- Must have a continuous improvement mindset with a willingness to accept and support change
- Ability and willingness to identify with and commit to the Philosophy and Mission and Values of The Sisters of the Third Order of St
- At least two years prior benefits experience preferred
- SHRM, GBA, CEBS, and/or CHRS (ACA) preferred
- Post- secondary education and a minimum of 5 years group insurance experience
- 2 years of experience in Relevant sales /marketing experience or the equivalent education and experience
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Benefits Representative Job Description
Job Description Example
Our company is searching for experienced candidates for the position of benefits representative. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for benefits representative
- Independently determines where to seek advice both inside and outside of company
- Conducts special, critical and analytical projects and surveys as assigned by supervisor, including Annual Election
- Monitor reporting to address timeliness and accuracy of the census and dispute resolution processes
- Support, plan and implement strategies and initiatives to improve operations and results including partnering with other internal departments
- Monitor and audit productivity goals, review level of progress and achievement, and recommend and implement measures for improvement
- This role will require an understanding of insurance carriers and concepts including drug cards, major medical benefits, and per diem coverage knowledge of government and patient assistance programs
- Knowledge of Medicare, Medicaid, and third party vendors a plus
- Qualified candidates will also need to portray strong attention to detail and proven analytic and problem solving skills
- Quickly build rapport and respond to customers in a compassionate manner
- Minimum 1 yr expereince in a customer service setting, or 6 months experience in a healthcare related role, or College graduate
Qualifications for benefits representative
- Requires high school diploma with 2-4 years of experience or an Associate’s degree in the focused areas of administrative and staff support services required
- Highly proficient with OneSource OAB, Word, Excel, Lotus Notes
- Knowledge of government and patient assistance programs
- Bachelor of Arts (BA) or Bachelor of Science (BS) Degree
- 6+ months of experience with medical insurance, benefits verification, medical billing or a related field
- Knowledge of Medicare, Medicaid, and third party vendors
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Benefits Representative Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of benefits representative. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for benefits representative
- Maintain a working knowledge of specific benefit programs, administration and processing as to service as a backup as the need arises
- Based upon diagnosis, estimated insurance coverage, and financial assistance, completes Patient Cost Estimate form
- Confirm C2WADT Workflow grid is cleared daily for all assigned facilities
- Coordinates and/or assists with corporate events such as the benefits seminars, 403(b) Education Meetings, job fairs
- SOME NIGHT AND WEEKEND HOURS WILL BE REQUIRED
- Develop manage and grow client and broker relationships for Brokerage business 30+ lives
- Collaborate with all internal support areas for successful implementation and ongoing account satisfaction for all accounts assigned
- Coordinate all services and aspects of account renewal including renewal rating strategy development and presentation to client
- Gather all carrier submission material and coordinate review and delivery of carrier contracts/policies
- Add ancillary services or other lines of coverage to assigned accounts in order to up-sell
Qualifications for benefits representative
- Possess a valid Life, Accident and Health license
- Minimum five years of work experience in Group Benefits and/or account management
- Must have a valid driver’s licence and a personal automobile
- Benefits or service experience
- CEBS or CHRS certifications
- Minimum three (3) years experience with health insurance verification ability to work with patients in discussing/collecting account balances