Employee Benefits Customer Service Representative

Corporate Synergies

. Handle claims resolution, benefits inquiries, coverage eligibility concerns, and related issues for clients’ administrators and employees .

Posted 10/6/2026full-timeRemote • 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, insurance processes, and benefit plan descriptions while effectively communicating with clients and managing inquiries. Proficient in Salesforce for client record management and analysis, with a strong focus on customer service and problem-solving.

Highest-signal resume keywords

Claims ResolutionInsurance ProcessesSalesforce ProficiencyMedical Coding and BillingCustomer Service Experience

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 ClaimsBenefit Plan Descriptions

Soft Skills

Verbal CommunicationWritten CommunicationOrganizational SkillsProblem-Solving SkillsMulti-Tasking

Tools & Technologies

SalesforceMicrosoft Office Suite

Industry Keywords

Insurance IndustryCustomer ServiceEmployee BenefitsPatient Advocacy

About the role

Key responsibilities & impact

Handle claims resolution, benefits inquiries, coverage eligibility concerns, and related issues for clients’ administrators and employees
Work with clients and carriers via phone and email to resolve matters within a 24-hour timeframe
Address employee insurance concerns and benefit-related questions
Assist with claims resolution, patient advocacy, and pre-certifications
Educate client employees on optimal benefit utilization and cost-effective plan options
Maintain detailed client interaction records in Salesforce and generate client analysis reports as needed
Use Salesforce to gather client information and enhance service quality
Monitor resolution timelines to close benefit issues and claims within designated timeframes
Review Summary Plan Descriptions and benefit summaries for accuracy
Provide expertise on insurance billing, coding, employee group benefits, insurance processes, and plan descriptions
Serve as a primary team resource for customer service and insurance/benefit issue resolution
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