Senior Benefits and Customer Care Specialist

4 weeks ago

Vaughan, Canada EightSix Network Inc Full time
Senior Benefits and Customer Care Specialist

Part Time / Full Time

Senior Benefits and Customer Care Specialist

We are seeking a highly skilled and experienced Senior Benefits and Customer Care Specialist to join our team, specializing in group insurance for the Canadian market. The successful candidate will be responsible for managing and optimizing the group insurance benefits experience for our clients, ensuring exceptional customer satisfaction and retention.

Essential Job Functions

Benefits and Client Administration and Daily Operational Tasks:

  • Oversee the implementation and ongoing administration of group insurance plans for clients.
  • Data enter and ensure accurate and timely processing of benefit enrollment forms, plan member changes, and terminations.
  • Collaborate with internal teams to resolve complex benefits-related inquiries and issues.
  • Liaise with sales, account managers, support team, and insurance carriers.
  • Efficiently manage a high volume of emails daily, ensuring timely responses by managing the shared servicing mailbox.
  • Maintain customer records by updating account information on the TPA system when required.
  • Provide administrative support to Plan Administrators and internal stakeholders.
  • Serve as the primary contact for a portfolio of group insurance clients.
  • Develop and maintain strong relationships with key client contacts, including HR professionals, benefits administrators, and executive stakeholders.
  • Provide personalized support to all Clients, internal and external.
  • Actively listen to client needs, concerns, and feedback, and proactively address issues to ensure high levels of satisfaction.
  • Assist with complex issues and inquiries, including but not limited to complex claims matters, authorizations, denials, appeals, and other issues, etc.
  • Maintain thorough knowledge of products/services offered by various group insurance carriers.
  • Educate plan members and administrators on all aspects of their benefit plan, as required.

Claims Management and Resolution:

  • Facilitate the claims process for clients, including initial claim submissions, adjudication, and resolution.
  • Investigate and resolve escalated claims issues in a timely and professional manner.
  • Identify opportunities for process improvements to streamline claims administration and enhance efficiency.

Implementation and Renewals:

  • Act as project coordinator for new business implementations as well as existing business when changes occur.
  • Coordinate and perform all activities related to implementations.
  • Conduct the annual renewal process which includes data gathering, analysis, and renewal report delivery to account managers.

Qualifications:

Bachelor’s degree in business administration, Human Resources, or a related field.

Minimum of 5 years of experience in group insurance benefits administration, with a focus on the Canadian market.

In-depth knowledge of group insurance products, including health, dental, vision, disability, and life insurance.

Strong understanding of Canadian regulatory requirements governing employee benefits.

Exceptional communication and interpersonal skills, with the ability to build rapport with clients at all levels of the organization.

Proven track record of delivering exceptional customer service and exceeding client expectations.

Detail-oriented with strong analytical and problem-solving abilities.

Ability to prioritize and manage multiple tasks in a fast-paced environment

Proficiency in Microsoft Office Suite and experience with benefits administration software preferred.

We offer a competitive salary, a comprehensive benefits package, and opportunities for professional development and advancement within the organization.

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The Vantage Talent Group in Vaughan, Ontario, Canada

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