Employee Benefits Customer Service Representative

Foundation Risk Partners

Employee Benefits Customer Service Representative for Foundation Risk Partners handling benefits inquiries and claims resolution for clients. Collaborating with clients and carriers through phone and email for timely resolution.

Posted 7/17/2026full-timeRemote • Florida, New Jersey • 🇺🇸 United StatesMid-LevelSenior💰 $22 - $25 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims resolution, benefits inquiries, and insurance processes while providing exceptional customer service. Proficient in Salesforce for data management and client interaction, with strong communication skills and a focus on timely issue resolution.

Highest-signal resume keywords

Claims ResolutionInsurance ProcessesSalesforce ProficiencyCustomer ServiceMedical Coding and Billing

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ResolutionMedical CodingInsurance BillingBenefit SummariesEligibility ClaimsData EntryClient Analysis ReportsPre-CertificationsEmployee Group BenefitsBenefit Plan Descriptions

Soft Skills

Verbal CommunicationWritten CommunicationOrganizational SkillsProblem-SolvingMulti-Tasking

Tools & Technologies

SalesforceMicrosoft Office Suite

Industry Keywords

Employee BenefitsInsurance IndustryClient InteractionPatient AdvocacyCoverage Eligibility

About the role

Key responsibilities & impact

The Employee Benefits Customer Service Representative handles claims resolution, benefits inquiries, coverage eligibility concerns, and other related issues for our clients' administrators and employees.
They work closely with clients and carriers via phone and email to resolve matters within a 24-hour timeframe.
Address client employee insurance concerns, answer benefit-related questions, and assist with claims resolution, patient advocacy, and pre-certifications.
Educate client employees on optimal benefit utilization and provide guidance on cost-effective plan options.
Maintain detailed records of client interactions, entering data into Salesforce and generating client analysis reports as necessary.
Use Salesforce to gather client information and enhance service quality.
Monitor resolution timelines to ensure benefit issues and claims are closed within the designated timeframe.
Review Summary Plan Descriptions (SPDs) and benefit summaries for accuracy.
Offer expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions to clients.
Act as a primary resource within the team, delivering exceptional customer service and support in resolving insurance and benefit-related issues.
Address member eligibility inquiries, enrollment entry and confirmation of coverage.

Requirements

What you’ll need

Three plus years’ experience working in customer service/call center environment.
Experience with an insurance industry carrier, broker, or insurance related vendor.
Knowledge of eligibility claims, medical coding and billing, etc.
Knowledge of benefit summaries and Benefit Plan Descriptions.
Exceptional verbal and written communication abilities.
Outstanding organizational and multi-tasking capabilities.
Strong problem-solving skills.
Skilled at taking initiative, prioritizing tasks, and meeting tight deadlines.
Proficiency in Spanish (both written and spoken) is a plus.
Collaborative team member.
Adaptable and detail-oriented.
Proficient in Microsoft Office Suite.