Plan Member Service Representative

2 weeks ago

Toronto, Canada Willis Towers Watson Full time

Plan Member Service Representative
- Toronto, CA

June 09, 2023

**The Role**

**Performance Objectives**:
**Clients and Employees**
- Provide efficient, professional service to meet client needs during new client launch, annual shopping window and throughout the year
- Support Client Implementation Project Manager and Business Analyst to investigate and respond to questions or concerns from client HR contacts
- Provide efficient, professional bilingual service (English and French) to support employees during new client launch, annual shopping window and throughout the year
- Participate in system and client-specific training sessions as required
- Handle inbound calls to BA call centre from clients’ employees in English and French on a range of benefits and administration topics during call centre hours
- Provide accurate, answers to employee queries and concerns, coordinating with administration team as needed to investigate and resolve questions
- De-escalate situations involving dissatisfied employees, offering patient assistance and support
- Guide callers through troubleshooting and navigating the Benefits Access site
- Reference client-specific knowledge base during calls to assist with answering questions
- Support expanded BA call centre hours during each client’s annual shopping window
- Document incoming calls using specific software
- Maintain BA service levels (e.g., call answer rate)
- Using established Excel tools and processes, perform initial and ongoing detailed technical checking of outbound reports to ensure accuracy and consistency of plan member data across all files and reports
- Create and maintain an organized system to track specific cases for special handling as advised by call centre team, administration team and project management team
- Examine individual employee data on system to ensure alignment with data in outbound reports
- Investigate any data anomalies and coordinate with broader team in order to resolve reporting questions before sending to carrier/client
- Complete technical review of files/reports to meet scheduled deadlines:

- Weekly eligibility files sent to applicable benefits carrier for each client to ensure employee, dependent and coverage data is complete and correct
- Weekly, bi-weekly, semi-monthly or monthly payroll files for each client to ensure products, dates, coverage level and associated employer and employee costs are represented correctly, including retroactive calculations
- Carrier monthly premium invoice for each client to ensure coverage details and associated costs are accurate and consistent with eligibility and payroll files, including retroactive calculations
- Perform additional data/reporting checks during overlap period to transition from one plan year to the next plan year
- Create and maintain Excel tracking tools and manage processes to support Benefits Access ongoing operations, including:

- Monthly call centre stats
- BA report schedule, by client
- Client/vendor product invoice preparation/tracking, coordination with finance
- Set-up of internal project codes for each client
- Other team management and project management tools, as directed
- Support Project Management team with new client implementations and renewals:

- Create/update individual product Benefit Summary documents
- Create/update Frequently Asked Questions (FAQ) document
- Create/update BA one-pager
- Create/update templated employee communication materials
- Coordinate French translation process for global requests and client implementation/renewal materials, as needed
- Attend and participate in periodic team calls and collaborate with other call centre representatives and broader project team to improve customer service

**Excellence**
- Ensure that Professional Excellence model is used consistently to ensure high quality of work
- Identify areas where service to clients and employees could be improved and/or expanded
- Use and maintain required filing protocols, tracking tools
- Strict adherence to WTW data security standards and policies

**People**
- Understand your role and how it interacts with the BA, configuration, consulting, call centre and administration teams
- Foster a collaborative working environment across the multi-disciplinary teams. Encourage teamwork by sharing knowledge, ideas and solutions
- Coordinate with local and global teams to ensure successful, timely customer service to clients and their employees
- Use judgement to escalate issues appropriately if required
- Participate in training and education sessions including systems, call centre tools/technology, client-specific knowledge base

**Financial**
- Understand and fully utilize WTW time recording systems in order to develop project budgets, track and report on time spent

.**Technical**
- Demonstrate sound knowledge of Canadian employee benefits, data and interfaces (payroll, HR, benefit provider reporting), benefit systems, employee support services and outsourced administration

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