Employee Benefits Claims Consultant

Acrisure

Claims Consultant providing guidance on employee benefits claims for public sector clients. Liaison between clients, carriers, and internal teams ensuring exceptional service delivery.

Posted 7/7/2026full-timeIselin • New Jersey • 🇺🇸 United StatesMid-LevelSenior💰 $58,000 - $62,000 per yearWebsite

About the role

Key responsibilities & impact

Provide proactive, technical consultative advice to public entity clients on employee benefits claim handling, trends, and outcomes
Serve as the primary point of contact for clients regarding employee benefits claim questions, concerns, and service-related issues
Deliver a high level of customer service by responding promptly to client inquiries and providing clear, professional guidance throughout the claim process
Advocate on behalf of clients and members to facilitate timely claim resolution and ensure a positive service experience
Educate clients on claims processes, benefit programs, coverage provisions, and available resources
Assist clients and Call Center Team members in navigating routine and complex claims issues involving medical, dental, vision, disability, life, and related benefit programs
Coordinate claim escalations with carriers and TPAs to facilitate timely resolutions
Investigate claim concerns by gathering information, tracking progress, and communicating updates to clients
Support appeals, grievances, and service-related claim challenges while maintaining a client-focused approach
Document claim activity, action plans, and outcomes to ensure accurate records and follow-up
Act as a liaison between clients, carriers, TPAs, and internal service teams to promote effective communication and seamless service delivery
Foster strong working relationships with carrier representatives and vendor partners to help resolve client concerns efficiently
Collaborate with account management and service teams to support overall client satisfaction and retention efforts
Participate in client meetings and serve as a subject matter resource related service matters
Coordinate periodic claim service reviews with clients, carriers, and internal stakeholders
Assist in preparing claim summaries, service reports, and trend information to support client discussions
Review claim service performance and identify opportunities to improve client experience and service delivery
Monitor service commitments and ensure follow-through on action items and client concerns
Provide training and educational support to clients regarding claims procedures, carrier requirements, and best practices
Develop user-friendly resources and presentations to help clients better understand claim processes and available benefits
Support internal education initiatives by sharing claims service trends, carrier updates, and client feedback
Support customer service representatives with complex claims
Identify opportunities to improve claims support processes, communication practices, and overall customer experience
Provide feedback to carriers, TPAs, and internal teams regarding recurring service concerns and client needs
Assist in developing best practices and service standards that enhance efficiency and client satisfaction

Requirements

What you’ll need

Bachelor’s degree in business or related field of study or equivalent experience required
3 – 5 + years of experience in employee benefits administration, claims customer service, carrier operations, TPA services, account management, or employee benefits consulting
Experience working with public entities (municipalities, school districts, counties, authorities, etc.) strongly preferred
Experience working directly with insurance carriers, TPAs, healthcare vendors, or brokerage organizations preferred
Active Life & Health Insurance License, or ability to obtain within 120 days of hire
Strong organizational skills- ability to prioritize and be proactive
Ability to adapt well to change in direction and priority in a fast-paced environment
Computer skills, specifically Microsoft Word, Outlook and Excel
Excellent verbal and written communication skills as well as strong interpersonal skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Claims ManagementEmployee Benefits ConsultingCarrier OperationsTPA ServicesAccount ManagementClaims Process EducationClaims DocumentationService Standards DevelopmentClaims Performance ReviewClient Relationship Management

Soft Skills

Strong Organizational SkillsExcellent Communication SkillsInterpersonal SkillsAdaptabilityProactive Problem Solving

Certifications

Active Life & Health Insurance License