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Top 50 Benefits Representative Skills

Below we've compiled a list of the most important skills for a Benefits Representative. We ranked the top skills based on the percentage of Benefits Representative resumes they appeared on. For example, 9.7% of Benefits Representative resumes contained Customer Service as a skill. Let's find out what skills a Benefits Representative actually needs in order to be successful in the workplace.

These are the most important skills for a Benefits Representative:

1. Customer Service

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high Demand
Here's how Customer Service is used in Benefits Representative jobs:
  • Provided telephone, online and face-to-face customer service support in stressful, high-volume communications center.
  • Utilized effective leadership strategies to coach/mentor 15 customer service representatives to improve customer quality.
  • Provided customer service to participants as needed.
  • Handle inbound, predominantly routine customer service calls, consistently demonstrating behaviors that contribute to the department's achievement of service.
  • Developed and maintained the customer service relationship of 42 clients which resulted in the organization meeting its yearly financial goals.
  • Provided customer service via phone and/or email with valid information for company owned vehicles programs of General Motors.
  • Provide customer service over the phone; answering all inquires regarding member benefits and eligibility.
  • Provided customer service to contracted clients for health and human services from 2006 to 2009.
  • Received numerous compliments and recognition from both members and clients for excellent customer service.
  • Provide internal customer service and assistance to employees yearlong regarding all benefit matters.
  • Provided exceptional customer service to diverse participants ranging from small to large companies.
  • Provide frequent customer service regarding payroll, benefits, scheduling, etc.
  • Demonstrated mastery of customer service call script within specified time frames.
  • Provide customer service to contracted companies & their employees.
  • Provided excellent customer service on a daily basis.
  • Delivered quality customer service to all clients.
  • Facilitated resolution to employee issues by utilizing internal resources to resolve Provided verification of coverage to providers resulting in customer service.
  • Delivered caring customer service in an empathetic manner; understanding and addressing their communicated needs.
  • Provided excellent customer service while deciphering each member s issue either in person or telephonically.
  • Perform all other duties as deemed appropriate to provide customer service Billing/ taking payments /coding claims

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2. Insurance Companies

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high Demand
Here's how Insurance Companies is used in Benefits Representative jobs:
  • Demonstrate strong interpersonal and persuasive abilities in order to secure accurate and timely payment from patients and insurance companies.
  • Communicated daily with clients, insurance companies and medical professionals.
  • Reconciled insurance statements and reported billing errors to insurance companies.
  • Gather necessary documents as requests by insurance companies.
  • Prepare commercial insurance correspondence (re-file claims; clarify information with insurance companies, follow-up calls on claim questions).
  • Conducted active follow-up with insurance companies for benefits verification, as well as responded to patient benefit queries and complaints.
  • Answer incoming calls from patients (and insurance companies) and provide account resolution while maintaining excellent customer service levels.
  • Researched patients' insurance coverage of specific drugs by communicating with patients, doctors, and insurance companies.
  • Negotiated fees, premiums and discounts with insurance companies, plan vendors including the Prescription Benefit Manager.
  • Review current policy coverage from other insurance companies and fill in the gaps with AIL insurance.
  • Operated successfully as the liaison between 15,500 employees and the insurance companies.
  • Acted as liaison between health plan members and other insurance companies.
  • Acted as liaison between insurance companies and employees when issues arose.
  • Acted as liaison between clients and various insurance companies.
  • Worked with insurance companies to enter and maintain employees.
  • Direct relationship with Health Insurance Companies.
  • Acted as liaison between healthcare providers and clients' insurance companies, to ensure the delivery of medications.
  • File pre-authorizations on behalf of the patients with insurance companies and provide follow up as needed.
  • Ensured United Healthcare members' policies were built correctly around other insurance companies' policies.
  • Verified insurance benefits for patients Confirmed patient information for medication approval Explained policy to patients and insurance companies

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1 Insurance Companies Jobs

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3. Benefits Administration

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high Demand
Here's how Benefits Administration is used in Benefits Representative jobs:
  • Process qualified status changes by sending updated information to the applicable carriers and updating related benefits administration systems.
  • Processed retirement distributions, prepared documents for audits, salary and benefits administration and terminations.
  • Compiled and maintained personnel records for benefits administration of high profile investment firm.
  • Cross trained with Benefits Team to obtain general knowledge of company benefits administration.
  • Conducted benefits administration for 1,000 benefit-eligible employees.
  • Answered phones in Service Center responding to customer inquiries regarding all aspects of health benefits administration.
  • Ensured data essential to benefits administration was entered into (and audited) in HRIS.
  • Job Duty: Outsourced benefits administration for an average of 2-3 clients at a time.
  • Worked with employees, responding to questions and resolving problems with benefits administrations.
  • Promoted to this position after 6 months as Receptionist in Benefits Administration.
  • Execute benefits administration for 2,400 employees nationwide.
  • Handled COBRA and retiree benefits administration.
  • Provided information and resolved any issues related to benefits administration.
  • Conduct New Hire Employee Orientation Conduct Benefits Administration and Communication
  • Provided subject matter expertise as relates to benefits administration.
  • Provide benefits administration for Prudential Financial in a call center Answer questions and creation of cases providing in depth research.

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4. COB

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high Demand
Here's how COB is used in Benefits Representative jobs:
  • Learned the knowledge base for Cobra, Flexible Spending Accounts such as Health Care Spending Accounts and Dependent Care Spending Accounts.
  • Serve as Quality Assurance lead on the processing of the clients daily carrier, payroll and COBRA files.
  • Provided subject matter expertise on COBRA, LTD, as well as other health and welfare programs.
  • Administered compliance of COBRA, Medicare, MedEx & retirement, dental, student & senior plans.
  • Maintained a working relationship with two Cobra administrators and acted as liaison with employee benefit issues.
  • Responded to questions concerning the Flexible Spending Accounts and COBRA processes, reimbursements, and terminations.
  • Prepare cobra notices to terminated employees participating in the MS State and School Insurance Plan.
  • Reimburse eligible members benefits which include health, dental, disability and Cobra.
  • Educated employees on laws pertaining to FMLA, Cobra, and IRS rules.
  • Enlist former employees in COBRA and help them to resolve related issues.
  • Provided COBRA benefits and enrollment details to participants and escalated as needed.
  • Coordinate and administer all FMLA, military leaves and issue COBRA.
  • Managed COBRA processing, creating/mailing average of 30 notices per day.
  • Authorized COBRA initial/offer letter, entered payments, and audits.
  • Managed all COBRA and DOL processes.
  • Educated employees regarding benefits, 401(k) plans, COBRA, HIPAA, FMLA, and disability plans.
  • Assisted human resource representatives, active associates and COBRA participants with benefit related questions and procedures.
  • Promoted to Cobra/Flexible Spending Account specialist - Researched, processed and presented participant appeals to client
  • Assisted employees with their Cobra and health benefits; handled issues in Human Resources in a professional manner.
  • Assisted COBRA Members with Benefit Questions, Corrected billing issues, Terminated policies per member's request.

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1 COB Jobs

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5. Payroll Deductions

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high Demand
Here's how Payroll Deductions is used in Benefits Representative jobs:
  • Managed garnishment and other court ordered payroll deductions.
  • Verified the calculation of monthly premium statements for all group insurance policies, and reported and processed insurance premium and payroll deductions
  • Answered incoming calls and questions from participants/retirees about benefits including health and welfare, retirement/401(k) and payroll deductions.
  • Enter research cases via Sales Force regarding enrollment issues, check research, payroll deductions and parking and transit accounts.
  • Administered all Section 125 benefits, including orientations, enrollments, changes, terminations, payroll deductions, etc.
  • Collaborated with Payroll/Finance, Human Resource, and other departments to ensure billing and payroll deductions were accurate.
  • Processed all 401(k) plan paperwork for enrollments, loans and payroll deductions.
  • Assist employees with payroll deductions, tax information, W2s, benefits deductions.
  • Utilize payroll database to assist employees with questions regarding payroll deductions and codes.
  • Handled escalated issues regarding payroll deductions, dependents, claim issues, etc.
  • Create client profile including demographics, payroll deductions and benefit package.
  • Adjusted payroll deductions to reflect changes in insurance coverage using Cyborg.
  • Process benefit driven payroll deductions on a bi-weekly payroll cycle.
  • Answer questions including deductibles, coinsurance and payroll deductions.
  • Maintained eligibility records, process enrollments, terminations, reimbursements and payroll deductions in a timely manner.
  • Managed associate payroll deductions for healthcare, disability and life insurance programs.
  • Assist payroll with testing bi-weekly and semimonthly checks making certain that benefit elections and premiums correspond with payroll deductions and timelines.
  • Answered questions about coverage premiums, and payroll deductions for participant healthcare coverage.

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6. Long-Term Disability

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high Demand
Here's how Long-Term Disability is used in Benefits Representative jobs:
  • Managed long-term disability and survivor income claims.
  • Tasked with administering the company's short and long-term disability programs, COBRA, and 401(k) program.
  • Managed FMLA, short-term/long-term disability, and worker s compensation claims.
  • Manage Short-term and Long-term Disability Plans for employees on LOA.

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7. Open Enrollment

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high Demand
Here's how Open Enrollment is used in Benefits Representative jobs:
  • Assist in the preparation and the dissemination of employee benefits-related communication packages and documents, including open enrollment periods.
  • Coordinate and facilitated new hire orientation and annual open enrollment.
  • Managed communication regarding employee orientation and open enrollment for benefits.
  • Coordinated annual open enrollment, including vendor selection and set-up.
  • Facilitated full-cycle, open enrollment.
  • Coordinate employee benefit services and information including new employee orientation, benefit fair, benefits open enrollment, etc.
  • Process benefits enrollments for employees at time of hire, during a life event, or at Open Enrollment.
  • Assisted with the annual open enrollment including explaining the changes and assisting associates with the new online system.
  • Provide consultative and enrollment services to employees during open enrollment and on a perpetual basis for new employees.
  • Organize open enrollment for medical / voluntary benefit plans, and execute monthly billing to vendors.
  • Performed annual open enrollment process, training, support, communications, reporting, etc.
  • Led a weekly open enrollment question and answer session with employees on benefit program updates.
  • Assisted with administration of employee benefit programs and annually with open enrollment for the employees.
  • Planned and implemented the Annual Open Enrollment and Health Fair for over 150 employees.
  • Assisted participants with open enrollment for various clients.
  • Participated in the Open Enrollment management team.
  • Handled open enrollment for 80,000 employees.
  • Assist client with open enrollment management.
  • Conducted 2010 retiree medical open enrollment.
  • Investigated and resolved any problems with eligibility or benefit coverage Responsible for the full administration of open enrollment period

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1 Open Enrollment Jobs

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8. HR

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high Demand
Here's how HR is used in Benefits Representative jobs:
  • Assisted corporate restructuring and workforce reduction effort through communication of severance packages and served as a point-of-contact for separated employees.
  • Develop and strengthen relationship with association members through face to face review and presentation of recommended benefits.
  • Provided extensive customer support through outward-bound call center while conducting investigative calls.
  • Provided customer service through outbound call center while conducting extensive investigative calls.
  • Increase existing association membership through new member recruitment.
  • Synthesized policy information and claims procedures in order to guide current employees and retirees through the health care enrollment and utilization processes
  • Assisted Target employees with benefit-related inquiries; educated store personnel on HR policy and procedure; mentored and trained new hires
  • Optimize expertise in health & welfare, 403b and pension benefits; manage multiple HR databases while maintaining confidentiality.
  • Reach out to providers or pharmacies for claims and prior authorizations for coverage for prescription drugs through OptumRx.
  • Developed new book of clients through various prospecting methods including, cold calling and telephone marketing.
  • Utilized multiple systems including MAX HR, Payroll, and Call Tracking to research questions.
  • Utilize necessary HR Resources and Partners to clarify information as needed prior to processing documents.
  • Ensured proper follow-through on all directives, bulletins and schedules from the Corporate Office.
  • Processed new enrollment and employment changes, guiding members through the process.
  • Assisted with implementation of the company's first HRIS (UltiPro).
  • Organize all HR department records, employment files and maintains office operations.
  • Generate new business through appointment setting campaigns in new territories.
  • Navigate through five different software programs, per call.
  • Time management thru heavy multitasking.
  • Monitored, distributed, and processed over 8,000 annual enrollment forms nation wide to meet a three-week deadline.

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9. Fmla

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high Demand
Here's how Fmla is used in Benefits Representative jobs:
  • Researched and administered Family Medical Leave (FMLA) benefits notifications.
  • Persevered and administered employees FMLA, Disability and vacation paperwork.
  • Conducted annual open enrollment benefits meetings and monitored FMLA, short-term disability, and workers' compensation files.
  • Maintained records and monitor compliance on all employee leaves: medical, FMLA, STD/LTD, personal LOA.
  • Assisted employees with their medical coverage selections, FMLA, 401(k), and adoptions.
  • Worked closely with Workforce Development on attendance tracking for Employees using LOA, FMLA and other leaves.
  • Meet with employees and managers for guidance on FMLA procedure or questions, and on HR policy.
  • Assist managers with FMLA documentation and informing them of employees taking and returning from leaves.
  • Develop, modify and conduct presentation of basic and refresher training FMLA and Benefits.
  • Managed FMLA administration, as well as both Short Term and Long Term Disability.
  • General familiarity with Discrimination, OSHA, Workers' Comp., FMLA laws.
  • Maintained record of FMLA and ADA usage to ensure compliance with labor laws.
  • Track employees who are on FMLA and answer questions relating to their rights.
  • Assist with administering and tracking of FMLA and various Leaves.
  • Manage FMLA and other leaves, continuous and intermittent.
  • Log and ensure FMLA leaves are administered appropriately.
  • Processed employee short term disability and FMLA request.
  • Process Family Medical Leave Act (FMLA).
  • Assisted LOA Coordinator with FMLA, PMLA, and LOA paperwork.
  • Managed FMLA, parental, and disability leave program and advised Accounting on payroll.

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10. Providers

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high Demand
Here's how Providers is used in Benefits Representative jobs:
  • Functioned as liaison between 3rd party providers and insurance vendors to resolve benefits eligibility/data and claim issues.
  • Provide assistance to inbound customer calls regarding inquiries and complaints concerning insurance benefits and medical providers.
  • Work closely with benefit providers to resolve eligibility errors generated by benefit providers.
  • Provide detailed explanations of benefits to members and providers.
  • Coordinate between General Dynamics and multiple providers.
  • Respond to Beneficiaries and Providers by letter and telephone regarding insurance claims and policies while staying in compliance with CMS guidelines.
  • Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
  • Administer enrollment and employee change information to plan providers, payroll and other plan administrators.
  • Negotiate and resolve claim and policy discrepancies between insurance carriers and health providers.
  • Consult medical, dental, vision and prescription providers regarding employee coverage.
  • Prepare correspondence to employees, medical providers, and insurance carriers.
  • Coordinated with providers to ensure claims were paid in timely manner.
  • Explained medical claims and payment to employees and medical providers.
  • Assist dental providers with claims and benefit information.
  • Look up ADA Dental Codes for Providers.
  • Established and maintained a positive relationship with the Department of Social Service, Hospital Administrators and other healthcare providers.
  • Generate revenue by scheduling payment arrangements Educate providers on our self-service options; handled extensive file review requests.
  • enroll new employees in health plan, coordinate coverage between providers and third party vendors
  • Assisted providers with pre authorizations and making sure we received clinical.
  • Worked with Healthcare providers to resolve member questions regarding benefit payments, coverage and additional questions.

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12 Providers Jobs

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11. Phone Calls

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high Demand
Here's how Phone Calls is used in Benefits Representative jobs:
  • Answer inbound phone calls regarding health and welfare benefits, assist callers with enrolling into health benefits, assist with training employees
  • Documented incoming and outgoing phone calls from General Motors employee's and addressed inquiries of customer complaints using Microsoft Access 2010.
  • Received 75-100 phone calls daily from Existing and prospective account holders with questions or concerns about6 their Health Savings Account.
  • Answered high volume telephone calls from members, providers and hospitals in a fast paced inbound call center environment.
  • Initiate telephone calls to members, providers, and other insurance companies to gather Coordination of Benefits data.
  • Trained other agents in making outgoing phone calls to potential clients and building strong, successful schedules.
  • Answer questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors.
  • Handled up to 100 phone calls per day concerning employee pensions and health benefits.
  • Answer incoming phone calls from members that may be calling a representative back.
  • Make phone calls to other insurance companies verifying member's policy information.
  • Maintained excellent client and employee relationships through phone calls e-mails and letters.
  • Make phone calls to members to inquire about their additional coverage.
  • Respond to telephone calls for members with marketplace policy member.
  • Receive phone calls regarding the request for medication for patients.
  • Answer phone calls from customers regarding their claims.
  • Answered benefits questions via email and phone calls.
  • Log phone calls into computer system.
  • Handled 75-100 phone calls a day.
  • Maintained positive client relationship and attended client phone calls Facilitated client specific training and regulation training.
  • Assist with multi-line telephone system and route incoming phone calls quickly

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12. Health Care

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high Demand
Here's how Health Care is used in Benefits Representative jobs:
  • Provided exceptional customer service to members and providers regarding health care benefits and insurance coverage.
  • Responded to questions from Health Care Professionals and/or members verifying enrollment and/or eligibility status.
  • Administer health care benefits for Ford Motor Company Salaried Retirees, Salaried Active, Active UAW Employees, and UAW Retirees.
  • Process and direct appropriate forms and Health Care Applications (HCA) as well as updating/closing associated claims in case management.
  • Prepared detailed responses to Health Care Financing Administration (HCFA) from client phone inquiries, correspondence and questionnaires.
  • Managed the data entry of employee enrollments forms, 401K and withdrawal requests in health care system.
  • Answered questions and provided support to clients; health care benefits, 401 K and Insurance.
  • Conducted enrollment meetings and seminars on health care reform and how it will affect clients business.
  • Facilitated employee training classes pertaining to health care benefits programs through on-site training sessions.
  • Assisted Health Care Finders (Nurses) in coordination of specialty referrals.
  • Answered inbound calls from prospects that were interested in beneficial health care.
  • Experience in the Medicare and or retiree benefits health care space.
  • Interpreted Health Care Reform Act and its impact on members.
  • Verify health care plans and Copay for patients.
  • Enrolled prospects into the health care plan.
  • Work collaboratively with pharmacists, health care providers, and customers to resolve prescribed medication circumstances and predicaments.
  • Provided Medicare plan specific information to Health Care Providers, Community Organizations, Case Workers, and the General Public.
  • Worked with current and prospective group health clients in regards to their specific health care needs.
  • Administered million dollar employee health care benefits program.
  • Greet and Provide customer service to Union Members Assist Members with their Health care needs Bi-Lingual Fluent in both English and Spanish

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4 Health Care Jobs

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13. Absence

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high Demand
Here's how Absence is used in Benefits Representative jobs:
  • Supported Life Administration Clients with Retirement benefits, Death and Leave of Absence claims and Portability/Convertibility Forms.
  • Leave administration research and resolve employee/HR questions relative to various leaves of absence: support benefits specialist with leave information.
  • Executed teamwork and flexibility in coverage of front desk in the absence of Administrative Assistant.
  • Manage leave of absences to ensure compliance with Federal, State and local laws.
  • Co-developed, launched and managed the ADP Total Leave of Absence Management system.
  • Assisted in the administration of the Leave of Absence and the Disability Program
  • Review, approve and track leaves of absence according to established guidelines.
  • Controlled all inquiries of leave of absence and determined approval or denial.
  • Generate and print all letters related to all Leave of Absences types.
  • Leave of absence administration in compliance with state and federal leave laws.
  • Administered employee leaves of absence program and FMLA compliance and tracking.
  • Manage the administration of leaves of absence and worker's compensation.
  • Meet with employees regarding leaves of absence and answering questions.
  • Coordinated and processed all areas of leaves of absence.
  • Served as member on Leave Of Absence Committee.
  • Trained as temporary Leave of Absence Team Clerical.
  • Represent and assist manager in their absence.
  • Maintained and administered leave of absence programs.
  • Administer leave of absence program for 10,000 employees Review all employee applications requesting leave of absences.
  • Recorded leave of absence payments Prepared spreadsheet for accounting department; sent necessary letters.

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1 Absence Jobs

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14. Data Entry

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high Demand
Here's how Data Entry is used in Benefits Representative jobs:
  • Perform various administrative duties including data entry and document preparation, medical claims status/resolution.
  • Assisted Payroll department with reconciliation and data entry.
  • Assisted with annual benefit open enrollment process, including report generation, employee follow-up, data entry, and benefit summaries.
  • Advised employees and managers on employment, benefits and payroll issues, data entry, insurance benefits, and educational assistance.
  • Maintain accuracy in benefits section of employee payroll files; data entry of all applicable withholding codes and amounts.
  • Developed and produced Flexible Spending Account Procedure Guide which eliminated 30 hours of manual data entry per month.
  • Assured the accuracy and completeness of all data entry of welfare benefit plans for employees.
  • Create a manual outlining the Benefit Representatives with any daily data entry system issues.
  • Assist with Annual Enrollment process including system testing, education and data entry.
  • Trained new employees on multiple medical billing programs and data entry software.
  • Process data entry in AON Hewitt system of all related benefits changes.
  • Performed biweekly audit of People Soft data entry.
  • Entered and maintained accurate comprehensive data entry of all referrals and verified insurance plan eligibility and benefit coverage.
  • Maintain accurate data entry and retrieval per Federal Medicare guidelines.
  • Participated in a four week training which included CBT evaluations, ICD9 coding, Seibel and Proxy data entry.
  • Complete assigned administrative assistant duties such as Data Entry, testing of systems, and employee information updating.
  • Received customers inbound calls, data entry, multi-tasked with the use of multiple lines and screens.
  • completed data entry, filing, worked with the Claims Adjusters to settle workers compensation claims.
  • Completed related data entry in an efficient manner.
  • Initiate case for possible Fraud claim by patient Gather pertinent documents per case review Distribute mail Data Entry

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1 Data Entry Jobs

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15. Life Insurance Benefits

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average Demand
Here's how Life Insurance Benefits is used in Benefits Representative jobs:
  • Responded to written correspondence regarding group health and life insurance benefits
  • Administered life insurance benefits to General Motors employees nationwide.
  • Counseled beneficiaries of deceased retirees on survivor benefits and commenced their medical, pension, and life insurance benefits.
  • Managed payments under New York State Disability Insurance and counseled employees concerning health, dental and life insurance benefits.
  • Utilize resources to locate union members and enroll them in the permanent life insurance benefits for which they qualify.
  • Scheduled appointments with clients in surrounding areas to enroll in the company's life insurance benefits.
  • Sell supplemental life insurance benefits to labor union and association members, their family and friends.
  • Administer medical, dental, vision, and life insurance benefits.
  • Handled any questions about life insurance benefits.
  • Enrolled eligible employees of various accounts in medical and life insurance benefits * Assisted account managers with billing and processing claims
  • Assisted employees with enrolling and/or cancelling medical or life insurance benefits.

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16. Health Benefits

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average Demand
Here's how Health Benefits is used in Benefits Representative jobs:
  • Provided resolution to employees regarding health benefits through constant communication with account executives.
  • Received calls and responded to incoming inquiries regarding participant health benefits.
  • Compiled health benefits literature packages and mailed to appropriate personnel.
  • Researched and explained summary of health benefits to participants.
  • Responded to general phone, mail and e-mail inquiries from members and employers regarding employer sponsored Pension Funds and Health Benefits.
  • Circulated information via mail correspondence to principals, teachers and employees of CMS regarding the various health benefits available.
  • Assist customers via phone and internet by fielding questions and solving inquiries regarding specific health benefits.
  • Handled in comically from clients who had questions related to their health benefits or insurance.
  • Process employee's health benefits, medical, dental and life and 401 k investments.
  • Researched claim and payment status, submitted claims and ordered health benefits cards request.
  • Educated employees and provided guidance about the health benefits offered by the company.
  • Researched member s health benefits and claim status by utilizing multiple computer programs.
  • Quoted mental health benefits to insured employees and the mental health providers.
  • Service employees of various companies with their health benefits and HR needs.
  • Assisted members by answering questions concerning health benefits and claims.
  • Provided information to employees on group health benefits questions i.e.
  • Assisted employees with the completion of health benefits applications.
  • Answer inquiries of employees about health benefits.
  • Enroll employees in their Annual health benefits
  • Answered up to 40 calls per day from employees related to health benefits, 401(k), and time-off.

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17. Hipaa

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average Demand
Here's how Hipaa is used in Benefits Representative jobs:
  • Maintain strict adherence to HIPAA and confidentiality requirements.
  • Trained newly hired and seasonal staff on Health and Welfare Benefits, COBRA compliance, HIPAA, and FMLA regulations.
  • Managed benefit administration policies including COBRA, FMLA, STD, LTD, HIPAA guidelines and life insurance.
  • Answered employee questions related to legislation and benefits laws regarding HIPAA Compliance, COBRA, and FMLA.
  • Trained in and applied HIPAA privacy and security regulations and maintained strict confidentiality of claims.
  • Certified HIPAA Professional, focused on protecting the employees and the organization as a whole.
  • Specialized in Health Care Reform and Complied with all HIPAA guidelines and regulations.
  • Maintain and adhering to strict HIPAA compliance protocols, standards and practices.
  • Key partner in the creation of HIPAA policies and communications.
  • Follow proper HIPAA compliance and aid in training new hires.
  • Produced weekly COBRA letters and ensured HIPAA compliance.
  • Served as back-up Privacy Officer under HIPAA.
  • Maintained compliance of HIPAA laws and regulations.
  • Follow HIPAA and JACHO regulations.
  • Administered COBRA and HIPAA compliance.
  • Ensured compliance with COBRA, HIPAA and IRS guidelines.
  • Operated in a HIPAA confidential environment Communicated with insurance parties and medical professionals on policy changes and eligibility.
  • Generated explanation of benefits, payments, and claim itemizations while adhering to HIPAA guidelines.
  • Comply with all HIPAA patient privacy laws while accessing healthcare information.
  • Prepared case notes to present to Kaiser Permanente Appeals Committee and Doctors HIPAA Compliant when discussing PHI with other outside entities.

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18. Welfare Plans

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average Demand
Here's how Welfare Plans is used in Benefits Representative jobs:
  • Provided benefit administration for multiple health and welfare plans, providing technical assistance and support to approximately 2200 employees.
  • Functioned as a HR & IS specialist for the implementation of Health & Welfare plans.
  • Designed and conducted new employee orientations and educated employees on company health and welfare plans.
  • Process departmental billing for Health & welfare Plans and various miscellaneous vendors.
  • Subject matter expert on client specific Health and Welfare plans.
  • Provide management advisory service and assistance to employees in administering benefits under the health and welfare plans for Greyhound drivers.

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1 Welfare Plans Jobs

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19. Hris

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average Demand
Here's how Hris is used in Benefits Representative jobs:
  • Produced benefit-related reports from HRIS.
  • Coordinate with Payroll, Shared Services, and the HRIS team to process employee actions are accurate within the HRIS.
  • Process all paperwork for associate benefit elections and changes in the various benefit plans using the HRIS system.
  • Utilized HRIS for input of enrollments, benefit deductions, eligibility, confirmations, and event maintenance.
  • Maintain personnel files for employees; Enter time and leave reports for staff using HRIS system.
  • Prepare and run benefits reports from HRIS system to reconcile against premium reports from carriers.
  • Administered changes into the HR Information System (HRIS) for payroll and HR.
  • Created management reports from the HRIS database in support of business expansion planning activity.
  • Process new employee benefit enrollment forms into Human Resources Information System (HRIS).
  • Entered confidential employee data updates into HRIS and managed information exchange with Payroll Services.
  • Processed employee benefit plan changes and qualified event transactions into UltiPro HRIS system.
  • Key member of the special implementation team for newly adopted Workday HRIS system.
  • Created, reviewed and updated personal forms and documents in HRIS.
  • Audited employee data in HRIS system for package rule violations.
  • Served as back up to Benefits/HRIS Representative for payroll processing.
  • Performed bi-weekly HRIS audits, investigated and corrected discrepancies to ensure data integrity.
  • Researched and resolved complex benefit problems Worked on identifying system errors and made corrections in HRIS system.
  • Maintain records of all data in the HRIS in a timely manner.
  • Enter new hires into the HRIS system (Lawson) Enter tax, direct deposit, etc.
  • Conducted New hire orientation Participated in salary surveys Assisted in entering employee records using an HRIS network.

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20. Medicaid

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Here's how Medicaid is used in Benefits Representative jobs:
  • Educated and Enrolled potential members about the benefits of a Medicaid managed care organization over traditional fee-for-service Medicaid.
  • Assist with securing benefits from Medicaid and charity programs including obtaining and completing all necessary eligibility documentation.
  • Checked Medicaid eligibility in systems, Scheduled doctors appointments, provided referral information.
  • Assisted patients in completing Medicaid application and obtaining required documents for expedient processing.
  • Benefit Administration for the Affordable Care Act for Medicare/Medicaid Qualified Beneficiaries.
  • Assisted Georgia Medicaid users in analyzing problematic issues pertaining to Medicaid.
  • Communicate with physician offices to obtain Medicaid Referrals.
  • Determined Medicare and Medicaid eligibility using interviewing methods.
  • Managed Medicare/Medicaid questionnaires and benefits surveys.
  • Obtained authorizations, benefits, and referrals for all Commercial, Workers Comp, Medicaid and Medicare Insurance.
  • Refer patients to Social Services for Medicaid, housing assistance, and other living needs.
  • Investigated and verified other insurance, such as Commercial, Medicare, and Medicaid.
  • Assist Medicaid and Medicare members/providers with benefit, claims, and other inquiries.
  • Support commercial as well as Medicare Part D and Medicaid patients.
  • Check patient's eligibility for Medicaid using the state system.
  • Follow state specific guidelines and special scenarios for Medicaid members.
  • Approved residents in HSP when Medicaid approved them.
  • Explained Medicaid Part A& B
  • Work to verify medical/pharmacy insurance benefits through contacting private insurance companies, Medicare and Medicaid to obtain benefit information.
  • Managed project mandated to onboard Newborn and newly eligible Peachcare for Kids/ Medicaid members through the Health Check program.

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21. ADP

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Here's how ADP is used in Benefits Representative jobs:
  • Perform quality assurance procedures per the parameters specified within ADP guidelines.
  • Conducted regular audits on the UltiPro system to verify the data is reliable and accurate by using reports from ADP payroll.
  • Inputted all benefit elections for new hires, qualifying events, and open enrollment while utilizing ADP.
  • Analyzed data to determine root causes of issues regarding the interaction of various ADP systems.
  • Worked with a small team to process biweekly payroll for approximately 2300 associates using ADP.
  • Interfaced with multiple ADP business partners including payroll, benefits and third party vendors.
  • Received electronic cases from ADP's Customer Service Center regarding employee's accounts.
  • Audit and edit benefits and benefit pay rates in the ADP TotalSource system.
  • Utilized ADP HRB/ Workforce Now to administer benefit programs for outsourcing clients.
  • Coordinated enrollment portal access and scheduling with 3rd-party payroll processor, ADP.
  • Assist client and ADP client team with Annual Enrollment project needs.
  • Update and maintain employees' benefit elections into the ADP system.
  • Process billing for medical dental and vision through BCBS using ADP.
  • Lean and navigate ADP system in order to resolve issue.
  • Respond to basic inquiries regarding ADP product and non-technical questions.
  • Processed select benefit reports from ADP payroll systems.
  • Converted manual personnel file system to ADP/Personnel.
  • Point of contact for ADP clients and their employees.
  • Complete HRIS tasks as needed in ADP.
  • Enter employee's personal changes into Benergy, Ceridian, ADP and Benefits vendors.

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22. Retirement Planning

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23. Pension Plans

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Here's how Pension Plans is used in Benefits Representative jobs:
  • Administer retiree pension plans including annuity check processing and account coordination.
  • Explained benefits options and choices regarding Health and welfare plans, Pension plans, and Tuition Assistance to faculty and staff.
  • Processed partial and lump sum distributions of pension plans to clergy and lay people of the United Methodist Church.
  • Responded to incoming calls/online chats, regarding medical, dental, vision, 401K, and pension plans.
  • Received inbound calls regarding health benefits, retirement savings plans and pension plans with USAA customers.
  • Managed pension plans for agency, interfacing with Plan trustees, actuaries, and participants.
  • Verified enrollment of insurance, endorsements, medical leaves, pension plans, stock options.
  • Assist with benefit audits for vision, dental and pension plans.
  • Assisted participants with changes and enrollment into the pension plans.
  • Pension plans * Pension offset plans * Pension/401k hybrid plans.
  • Advise participants of their COBRA and pension plans.
  • Provided resolutions to the associates regarding pension plans.
  • Maintained pension plans to includecompleting annual reports, distributing pension statements and processing distributions as required.
  • Answered all benefit-related information on Savings and Pension Plans in a professional manner.
  • Hired from contract position to administer pension plans for 10 clients including Pepsi and other large corporations.

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24. Insurance Plans

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Here's how Insurance Plans is used in Benefits Representative jobs:
  • Prepared calculation of monthly premium statements and reconciled invoices for insurance plans.
  • Answered inquiries about medication coverage for specific pharmaceutical insurance plans.
  • Assist participants w/qualifying life events, open enrollment, verification of health insurance plans, FMLA, 401k, STD & LTD
  • Licensed in Accidental and Health Insurance for the state of Illinois, appointed to sell health insurance plans in 12 states.
  • Organized and maintained the administration of annual enrollment and renewal of insurance plans which resulted in commissions for the producers.
  • Explained insurance plans for client's employees, to allow the employee to choose plans to fit their needs.
  • Processed death claims for life insurance plans to provide beneficiaries with instructions and required paperwork for distribution of benefits.
  • Handled NC and SC territory to set up new group health insurance plans for small business clients.
  • Explain features, advantages and disadvantages of various policies to promote sale of insurance plans.
  • Negotiate pricing for the renewal of the health & dental insurance plans with the vendors.
  • Interpreted contents of group insurance plans and referred questionable cases to an analyst or manager.
  • Assisted with changes in health insurance plans, such as adding or dropping dependents.
  • Managed open enrollment in health insurance plans for over 12,000 subscribers in 66 municipalities.
  • Process life events and made appropriate changes to their insurance plans.
  • Prepare, reconcile and remit payments and invoices for insurance plans.
  • Assist in the Changing of Insurance plans for open enrollment.
  • Worked with commercial and government insurance plans.
  • Organized personal files and insurance plans.
  • Assisted in the explanation and the answering of questions concerning health/dental insurance plans via telephone and e-mail.
  • Contacted the insurance plans directly to fully clarify some of the plan policies.

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25. Peoplesoft

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Here's how Peoplesoft is used in Benefits Representative jobs:
  • Track and monitor employee benefits eligibility, ensuring selected plans are visible in PeopleSoft and other company proprietary systems.
  • Provided assistance with Disaster Recovery and PeopleSoft systems upgrade to increase the efficiency of benefits program function and administration.
  • Validate and maintain accurate information in HRIS PeopleSoft system and retrieve pertinent information retained for reporting and billing purposes.
  • Ensured terminations and rehires were processed correctly in PeopleSoft database.
  • Accepted and posted payments to accounts using the PeopleSoft HR database application, and notified insurance carriers of continuation of service.
  • Participated in the PeopleSoft 9.1 upgrade by running tests and scripts to make sure the system was set up correctly.
  • Utilized PeopleSoft HR 8.3 to process all employment related data, payroll deductions and benefits changes.
  • Processed and inputted enrollment and change forms into PeopleSoft and insurance carriers' websites.
  • Guide employees through the process of HR Self Service online using PeopleSoft.
  • Initiated and maintained record keeping for claims and benefits calls in PeopleSoft.
  • Prepare Monthly Workforce Reports for VP HR via PeopleSoft HRIS system.
  • Administered employee data utilizing PeopleSoft for 2800+ employees.
  • Coordinated arrears with Payroll and process in PeopleSoft.
  • Input and corrected employee benefit deductions using PeopleSoft.
  • Created reports using PeopleSoft query.
  • Created diagnostic reports/queries using Peoplesoft.
  • Review and code insurance invoices; run and generate reports such as PeopleSoft, Epicor and excel reports.

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26. Special Projects

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Here's how Special Projects is used in Benefits Representative jobs:
  • Reported directly to upper management regarding special projects, and participated in cost savings initiatives including the Health Care Education Committee.
  • Served as representative on special projects responsible for revising policy and procedures and creating standardized letters.
  • Participate in special projects and other regional initiatives as requested by management
  • Managed special projects including the COBRA/Retiree benefit plans and educational assistance.
  • Performed special projects as deemed necessary by the Client Services Manager, such as implementation process for new on boarding clients.
  • Worked individually and in team settings to complete special projects to ensure that all employees were enrolled properly in benefit options.
  • Work collaboratively with other associates and supervisor on special projects as assigned to ensure that best practices are shared.
  • Worked closely with Insurance Administrator on special projects related to OSHA, Workers' Compensation and Employee Injury Claims.
  • Work closely with the Director of Benefits on special projects within the department and for the organization.
  • Work on special projects to improve the knowledge tool and plan coordination.
  • Lead various special projects for management and performed other duties as assigned.
  • Coordinated with management team on special projects to meet client needs.
  • Perform special projects as deemed necessary by the Client Services Manager.
  • Showed teamwork skills by assisting in other departments and special projects.
  • Provide support and assistance to the director on special projects.
  • Participated in several special projects within the call center.
  • Collaborate with coworkers to complete special projects.
  • Assisted with special projects as needed.
  • Work on special projects as needed.
  • Assisted Employee Relations on special projects.

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27. Hippa

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Here's how Hippa is used in Benefits Representative jobs:
  • Maintained confidentiality regarding rules around HIPPA guidelines.
  • Standardized processes and accommodated to HIPPA guidelines
  • Communicated legal guidelines regarding workers compensation, unemployment, disability, COBRA, HIPPA, and Section 125 cafeteria plans.
  • Maintained current knowledge of regulations pertaining to Health Insurance Portability and Accountability Act of 1996(HIPPA).
  • Created policies, procedures and documents for Section 125, COBRA, FMLA and HIPPA compliance.
  • Provide information to clients, pharmacists and doctors regarding patients benefit drug coverage within HIPPA guidelines.
  • Educated callers on policies and procedures, HIPPA, authorizations such as Power of attorneys.
  • Assured compliance with HIPPA, Patient's Rights of Responsibilities and financial assistance.
  • Adhered to HIPPA regulations and company's patient confidentiality policies and procedures.
  • Complied with all HIPPA regulations and have completed training.
  • Assure compliance with HIPPA and other government regulations.
  • Initiated and produced HIPPA certificates when applicable.
  • Maintain HIPPA and other regulated compliance
  • Follow HIPPA laws and regulations.
  • Researched insurance claim discrepancies and made recommendations for resolutions including Cobra, HIPPA, and medical underwriting.
  • Complete training and certification programs from organizations such as HIPPA Use probing questions and leverage information.
  • Responded to ACD calls on provider and client eligibility using HIPPA regulations and compliancy.
  • Enrolled current employees and retirees in benefit programs Adhered to all HIPPA regulations
  • Follow HIPPA and Compliance guidelines Meet and maintain quality and productivity standards Provide world-class customer service
  • Processed Court Orders to enroll employees for benefits * Followed HIPPA guidelines in all work practices and procedures.

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28. Life Events

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Here's how Life Events is used in Benefits Representative jobs:
  • Organized and distributed courtesy enrollment electives and updating new dependent information or life events for participants.
  • Managed enrollments, life events, and COBRA in compliance with state and federal laws, and University policies.
  • Processed enrollments, life events and employee changes submitted through Employee Access in accordance with documented customer procedures.
  • Entered data and ensured accuracy of new hire enrollment forms, category changes, and qualified life events.
  • Process all pending enrollments, life events and employee changes submitted employees via Employee Access.
  • Assisted plan members with web based enrollment and benefit changes relating to qualified life events.
  • Provided support to employees with benefit questions, claims, orientations and life events.
  • Documented process procedures for new benefits call center, projects, and life events.
  • Received and accounted for all incoming documents including proof of major life events.
  • Orchestrated new hire enrollments, qualifying life events, and annual enrollment updates.
  • Processed employee Qualifying Life Events: Marriage, Adoption, Newborn, etc.
  • Processed employee life events and also corrected employee records in self-serve and Oracle.
  • Assisted clients with enrolling into benefits during life events or annual enrollment.
  • Process approval/denials for Life Events and Life Insurance reports.
  • Provide benefit enrollment and life events services.
  • Administered health benefits including enrollments, terminations, COBRA, billing and life events for The Claremont Colleges faculty and staff.

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29. FSA

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Here's how FSA is used in Benefits Representative jobs:
  • Administered benefit programs such as medical, dental, FMLA, disability, life insurance, FSA, etc.
  • Counseled participants on options available for life and health insurance, HSA s, FSA s and other benefits.
  • Monitor and review receipts, Explanation of Benefits and Letter of Medical Necessity to validated FSA eligible expenses.
  • Ensured FSA/HAS enrollments were correct based on effective date, annual contribution amount and any YTD contributions.
  • Contacted any FSA or HRA groups concerning any outstanding payments for claims and/or admin fee invoices.
  • Service consumers inbound inquires via phone and live chat regarding HRA, FSA and HSA accounts.
  • Assisted with Cobra and FSA plan administration; researched and resolved all Cobra related inquiries.
  • Enrolled participants in selected medical, dental & FSA benefits.
  • Assist employees with the medical, dental vision, FSA, Life, LTD and COBRA plans.
  • Helped fsa, hsa and commuter program participants with website navigation and program report reviews.
  • Assisted and resolved participant's issues, * Completed customer transaction requests * Maintain salary/hourly accounts * Maintain FSA accounts

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30. Outbound Calls

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Here's how Outbound Calls is used in Benefits Representative jobs:
  • Answer inbound and place outbound calls, service existing accounts, obtain orders and determine charges for requested products.
  • Handled inbound and outbound calls with the highest quality customer service while maintaining schedules and deadlines.
  • Handled a high influx of inbound/outbound calls within a dynamic call center environment.
  • Completed outbound calls to plan members to update personal information for files.
  • Verified other insurance coverage through extensive research, outbound calls.
  • Make outbound calls to doctors offices for follow up information.
  • Performed outbound calls to doctors and customers as required.
  • Interacted with agents and policyholders by outbound calls.
  • Place outbound calls to participants and Doctor Offices.
  • Received inbound calls and made outbound calls.
  • Serviced coordination for inbound and outbound calls to patients regarding drug prescription refills, PBM benefits and pre-authorization status.

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31. Status Changes

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Here's how Status Changes is used in Benefits Representative jobs:
  • Processed benefit enrollments including new hires, status changes, major life events, payroll errors, transfers and data corrections.
  • Assisted employees with benefit enrollments and family status changes (birth, divorce, marriage, death etc.)
  • Processed family status changes, class changes, new hire paperwork, 403 B changes, and general deductions.
  • Create data entry guidelines outlining the process to make correction or updates to an employee health coverage status changes.
  • Processed employee enrollment changes with carriers, including new hires, status changes, qualifying life events and terminations.
  • Start and stop coverage due to status changes and notify associates when eligible to enroll in benefits.
  • Entered new member enrollment and status changes with existing employee using the appropriate vendor procedures.
  • Maintained and updated all dependent and status changes to the Union Benefits contract.
  • Processed qualified benefit status changes in accordance with IRS regulations.
  • Review of all employee status changes for possible benefits implications.
  • Assisted employees with their benefits and family status changes.
  • Managed and coordinated employee/retiree records, benefit elections, 401K, FMLA, fulltime student information, and family status changes.
  • Respond to benefits inquiries from managers and employees on plan provisions, benefits enrollments, status changes and other general inquiries.
  • Process employee benefit changes in response to qualifying life event and status changes Update eligibility with carriers when necessary.
  • Processed benefits enrollment and family life status changes (birth, adoption, marriage, etc.)
  • Created new files and arranged for direct pay when necessary.Explained and processed Section 125 family status changes.

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32. HMO

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Here's how HMO is used in Benefits Representative jobs:
  • Maintained up-to-date knowledge on federal and state legislation and regulations pertaining to HMO membership, fraud, and operations as provided.
  • Examined HMO documents to verify eligibility to process or reject into or from a managed care plan when necessary.
  • Organized file cabinets and re-arranged order of health insurance booklets according to states, PPO's and HMO's.
  • Monitored, evaluated, and counseled employees regarding HMO, PPO, and POS health benefits.
  • Assisted employees with open enrollment process and answered questions regarding PPO and HMO insurance plans.
  • Processed paperless medical claims handled PPO and HMO products Medicare Processing and other insurance COB processing
  • Served as Account Representative for Prudential, Kaiser and HMO Blue for over 60,000 employees.
  • Managed HMO benefits enrollment including medical, dental, and life insurance.
  • Loaded new membership group data via tape-in process for 225,000 HMO members.
  • Negotiated HMO premium rates with six health care vendors nationwide.
  • Educated participants on HMO and PPO benefits.
  • Reviewed HMO health change forms.
  • Experience in POS, HMO, INDEMNITY, PPO claims and benefits.
  • Acted as a primary contact for 10 HMO and 4 POS carriers regarding enrollment issues.Processed paperwork related to death benefits.
  • Supervised 50 customer service reps Negotiated our contracts with 17 different HMO's and our self-funded indemnity plan.
  • Work with Payroll on bi-weekly payroll production Audit & disburse monthly HMO contracts for various benefits.
  • Verified insurance claims for HMOs, PPOs, Medicare and Medicaid in a hospital setting for collection of payment.
  • Executed and coordinated HMO enrollments with out of state employees.
  • Served as key contact for NYLCare/NYLife and Cigna HMO eligibility and benefit issues.

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33. New Clients

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Here's how New Clients is used in Benefits Representative jobs:
  • Seek out new clients and develop clientele by networking to find new customers and generate lists of prospective clients.
  • Keep records, prepare reports, find new clients and help settle insurance claims.
  • Calculate premiums and establish payment method for new clients.
  • Make custom power points to highlight each of the benifits new clients will obtain while sign with us.

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34. Claims Issues

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Here's how Claims Issues is used in Benefits Representative jobs:
  • Escalated employee benefits claims issues to gain satisfactory resolution.
  • Answer employee question and make suggestions concerning employee benefits, network/provider selection and problems with payment of benefit plan claims issues.
  • Quoted benefits, requested medical cards, researched claims issues, located providers and returned calls to members.
  • Prepared written correspondence to clients, participants and third party vendors; assisting with claims issues and appeals.
  • Research and analyze claims issues ranging from routine to complex * Review and process health claims.
  • Work with other operational departments to research and resolve benefit enrollment and or claims issues.
  • Acted as liaison between benefit carriers and employees to resolve claims issues or coverage questions.
  • Assisted Plant Benefits Representative with resolving medical claims issues for hourly and retired employees.
  • Served as an employee advocate to benefits/insurance provider and administrators for claims issues.
  • Investigated and served as employee liaison in resolving benefits claims issues with vendors.
  • Assist employees with inquires and requests and their insurance claims issues.
  • Worked with benefits advocacy team to resolve escalated claims issues.
  • Resolve claims issues acting as liaison with vendors and employees.
  • Handled employee benefits questions and complex claims issues with insurers.
  • Assisted employees with claims issues and verified monthly statements.
  • Resolved escalated claims issues with employees and carriers.
  • Assist with claims issues with insurance carriers.
  • Answered high volume of incoming calls regarding benefit related questions, including claims issues, deductible inquiries, and premium questions.
  • Established and maintaining data and files, Researched inquiries for claims issues.
  • Served as an employee advocate to benefit providers forclaims issues.

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35. Problem Resolution

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Here's how Problem Resolution is used in Benefits Representative jobs:
  • Attended calls for problem resolution related to benefit management.
  • Performed research and problem resolutions.
  • Communicate to customers, specific coverage options, cost comparisons, life event processing and assist with problem resolution.
  • Serve as the day-to-day contact to clients and participants for problem resolution, transaction issues and data questions
  • Calmed angry callers, repaired trust, located resources for problem resolution and suggested best-option solutions.
  • Perform research and problem resolution using multiple systems tools to assist with benefits open enrollment.
  • Assist in complex problem resolution, and hands-on on in resolving escalated issues.
  • Provide advice and problem resolution to manager and employees on a daily basis.
  • Executed research and problem resolution and handled cases from participant call center.
  • Performed research and problem resolution using multiple systems, tools and resources.
  • Act as liaison between employees/service providers and assist in benefit problem resolution.
  • Initiate research, advise and guide participants to successful problem resolution.
  • Provided technical research to complete third party requests Performed research and problem resolution using multiple systems, tools and resources.

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36. Medical Benefits

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Here's how Medical Benefits is used in Benefits Representative jobs:
  • Supervised a group of 15 Benefits Representatives in a call center environment administrating Pacific Bell and Southwestern Bell medical benefits.
  • Promoted to interpret and investigate medical benefits for union employees.
  • Enroll Participants in medical benefits and effectively explained coverage details
  • Responded to associates' inquiries regarding Medical Benefits.
  • Receive inbound medical claim calls, review and inform clients of medical benefits and claim coverage.
  • Make and receive calls to obtain eligibility and or major medical benefits.
  • Understand the commercial insurance concepts including drug cards and major medical benefits.
  • Stock Purchashed Program, Medical Benefits, Leave Program, and Retirement Programs.

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37. STD

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Here's how STD is used in Benefits Representative jobs:
  • Required complete knowledge of company benefits plans, including health/welfare, Annuity/401K, Life, STD, LTD, Flex Benefits.
  • Reconcile monthly bills for all employee benefits, Health, Dental, Life and STD, LTD, Basic Life insurance.
  • Explained and administered leave programs, such as FMLA, STD, LTD and personal leave of absences.
  • Leave administration (FMLA, military, medical, personal, STD, bereavement, etc.).
  • Resolve and/or assist in resolving payroll errors related to Paid Time Off (PTO) and STD.
  • Create & process FMLA/STD paperwork while communicating with employees of approval or denial of benefits.
  • Enrolled participants in medical, dental, vision, life, STD, LTD.
  • Process STD and LTD if applicable.
  • Assisted associates with leaves of absence using policies on STD, LTD, FMLA, and ADA.
  • Maintained and tracked employees on LOA's: STD, LTD, FMLA and WC claims.

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38. High Volume

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Here's how High Volume is used in Benefits Representative jobs:
  • Receive and screen a high volume of internal and external communications, including email and mail.
  • Worked in a centralized call center environment and answered a high volume of incoming phone calls.
  • Managed high volume of correspondence to be classified and distributed to the field.
  • Maintained professional manner in high volume times and can handle.pressure very well.
  • Trouble shooting a high volume of incoming calls regarding patients Medicare plans.
  • Attached benefit investigation worksheets during high volume influxes along with patient assistance forms to Centocor after documents are faxed into Kofax.
  • Managed high volume of healthcare calls on Benefits Hotline.

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39. Company Policies

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Here's how Company Policies is used in Benefits Representative jobs:
  • Determined best method to resolve problems, ensuring customer satisfaction and adherence to company policies.
  • Counseled salaried and hourly personnel regarding employee benefits eligibility and company policies.
  • Facilitated conferences and negotiations regarding company policies for training purposes.
  • Provided instructions on company policies and procedures.
  • Maintained and update leave of absence correspondences to ensure compliance with FMLA, ADA and other company policies.
  • Educate the customers on company policies and offer assistance to enroll customers in services that meet their needs.
  • Maintained knowledge of company policies in accordance to California state laws and multiple insurance companies' policies.
  • Keep detailed, organized record of changes in Workers' Comp laws, carrier and company policies.
  • Administer various employee benefit health & welfare plans, ensuring compliance with company policies.
  • Processed daily fund transfers, provided counsel on investment options and company policies.
  • Conducted orientations for new employees regarding company policies, procedures and o benefits.
  • Trained the customer service on company policies and regulations.

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40. IRS

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Here's how IRS is used in Benefits Representative jobs:
  • Provided complete and timely data necessary for monitoring compliance with IRS regulations.
  • Interacted with the retirement system regarding balances and first eligible retirement dates
  • Coordinated and conducted benefit fairs.
  • Received recognition in Annual Report for selling one of the first group auto programs, a newly-introduced product.
  • Manage incoming client emails and phone calls, reviewing & processing claims in accordance with IRS guidelines.
  • Acted as first point of contact for inquiries related to Benefits through HR Service Center phone line.
  • Provided concierge level service to providers by resolving provider telephone inquires at first point of contact.
  • Travel to Benefit Fairs educating employees about company sponsored benefits for themselves and their families.
  • Partnered with field reps to exceed quota for first quarter of fiscal year.
  • Participated in benefits fairs, Annual Enrollment, and dependent audit projects.
  • Attend Job Fairs to help recruit new employees to the University.
  • Attended county, city, and high school job fairs.
  • Serve as first point of contact for payroll benefit coordinators.
  • Act as the first-point of contact for computer issues.
  • Organized recruitment activities for job fairs and college recruiting.
  • Performed first notice of loss claims intake.
  • Supported with Job Fairs as needed.
  • Perform first-party collections using auto-routed inbound/outbound dialer software.
  • Helped organize wellness events to include: Health Fairs, Blood Drives, and weight-management groups (i.e.
  • Advised and educated participants on Plan Rules and IRS guidelines for 401Ks'.

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41. Plan Participants

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Here's how Plan Participants is used in Benefits Representative jobs:
  • Drafted new benefits manuals and improved existing documents to ensure accurate state and federal compliance and clear communication to plan participants.
  • Conduct detailed benefit and eligibility verification of insurance benefits for plan participants.
  • Coordinated and processed annual enrollment for plan participants, ensuring accuracy.
  • Managed benefits investigations for Plan Participants.
  • Responded to telephone inquiries from plan participants regarding account information, investment options, plan details, and general account questions.
  • Assisted plan participants with enrolling, modifying elections, withdrawing and receiving payouts from employee administered 401K retirement plan.
  • Consulted and educated plan participants on their 401k investments and the best method to achieve their retirement goals.
  • Process Savings Plan contributions, loans and withdrawals by plan participants and participating employers.
  • Audited calls of CRS's to ensure accurate information is provided to plan participants.
  • Provided services to 401k plan participants in major U.S. corporations.
  • Educate plan participants regarding plan rules and guidelines.
  • Assisted plan participants with documents and questions.

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42. Benefit Packages

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Here's how Benefit Packages is used in Benefits Representative jobs:
  • Maintained knowledge of several benefit packages to support all company locations.
  • Supported client accounts for employees that have benefit packages in 401(k), medical and pension plans.
  • Prepare and mail benefit packages to participants and assist in the completion/review of all participant election forms.
  • Prepared warrants and forms for manual processing and appropriate benefit packages, for both retirees and survivors.
  • Analyzed and prepared accounts, comprehensive retirement and death benefit packages for employees and their families.
  • Advise and assist customers with building benefit packages including medical, dental and vision.
  • Coordinated, regulated all new employee benefit packages and payroll status changes and questions.
  • Set up in-home appointments to deliver benefit packages.
  • Expanded benefit packages for existing clients.
  • Created voluntary benefit packages for small businesses Responsible for prospecting and opening new accounts.
  • Worked with the HR departments of various fortune 500 companies in regards to the benefit packages being set up for their employees
  • Deliver union members' benefit packages Maintain great relationship with clients Make sure families are properly protected
  • Obtained knowledge on benefit packages Trained on HIPPA policies Consulted employees on annual enrollment policies
  • Reached Tier 4 in sales production Expanded benefit packages for existing clients Solicited new clients

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43. Erisa

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Here's how Erisa is used in Benefits Representative jobs:
  • Dedicated disability representative responsible for processing and reviewing disability claims for ERISA health and welfare trust participants.
  • Work with Reconciliation and Tax groups to ensure proper withhold of FICA taxes for participants in non-qualified ERISA plans.
  • Managed the COBRA administration while upholding HIPPA and ERISA laws and regulations.

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44. Confidential Information

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Here's how Confidential Information is used in Benefits Representative jobs:
  • Maintained Business Associate agreements for vendors responsible for providing confidential information to other vendors.
  • Handled confidential information with sensitivity and discretion in accordance with data privacy requirements.
  • Entailed being entrusted with highly confidential information.
  • Managed critical and confidential information for participants.
  • Maintained confidential information, such as pay rates, bonus targets and pay grades.

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45. Plan Documents

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low Demand
Here's how Plan Documents is used in Benefits Representative jobs:
  • Review and implementation of client materials such as plan documents, complex benefit calculations and administration manuals.
  • Revise plan documents and execute benefits communication plan company-wide, in conjunction with Benefits Manager.
  • Investigated employee complaints; interpreted benefit plan documents and resolved problems.
  • Reviewed and interpreted pension plan documents.
  • Corresponded with and assisted contracted legal firm regarding QDRO's, appeals, plan documents, contract inquiries and disputes.
  • Assisted members by deciphering plan documents, describing plan benefits, and explaining benefit plan policies and procedures.
  • Assist in review of communication pieces of forms, to ensure that they are consistent with plan documents.
  • Ensured all benefit plan documents, summary plan descriptions, booklets and information brochures were accurate.
  • Implemented and updated annual changes to summary plan documents, enrollment guides, OE mailers.
  • Oversee the development, maintenance, and distribution of plan documents and required notifications.
  • Interpreted plan documents to assist employees plan and utilize their benefits.
  • Test system changes against client plan documents.

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46. PPO

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low Demand
Here's how PPO is used in Benefits Representative jobs:
  • Provided Bilingual Customer Support for benefits enrollment for large companies
  • Identify membership growth opportunities in an assigned territory.
  • Supported Prudential Retirement with retiree issues.
  • Schedule my own appointments in order to deliver no cost benefits and present with Insurance policies available for purchase.
  • Respond to inbound calls with the expectation of providing high level customer service and support to clients.
  • Set up appointments for prospective retirees to speak with benefits manager and prepare for the retiree process.
  • Acted as a liaison with UltiPro support staff to ensure that any issues are quickly resolved.
  • Complete Pension Specialist II training and continue to support Health & Welfare clients through Annual Enrollment.
  • Compiled, analyzed, and synthesized data for C-level executives in support of high-level decisions.
  • Supported the General Motors Company Owned Vehicle program in reviewing cases for potential fraud.
  • Compiled and investigated detailed outcomes of ongoing audits via Microsoft Office support 2010.
  • Scheduled appointments to visit the homes of union members and their sponsors.
  • Handle client and vendor queries as well as extended support when needed.
  • Work with others in the Benefits Department to support all benefit efforts.
  • Provide support to and train other researchers within the department.
  • Present benefits program at appointments.
  • Sell Fidelis Care products and services by identifying membership growth opportunities in an assigned territory.
  • Provided analytical and technical support for projects as assigned.
  • Processed Evidence of Insurability Forms, Qualified Medical Child Support Orders, New Hire and Qualified Life Events.
  • Schedule appointments with clients twice weekly, and answer and questions they have.

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47. Retirement Benefits

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low Demand
Here's how Retirement Benefits is used in Benefits Representative jobs:
  • Work with clients to explain, calculate, and process retirement benefits for retirees, specifically assigned to Spanish speaking clients.
  • Initiated commencement of retirement benefits as well as maintained retirement plan history, correspondence, reports and forms.
  • Assisted active and retired employees resolve issues with health, welfare, pension and retirement benefits.
  • Handle inbound and follow up calls related to health, savings, and retirement benefits.
  • Provide support with all retirement benefits planning efforts and strategies.
  • Walked employees through enrollment process for retirement benefits.
  • Assisted retiree participants with billing inquiries Gave retirees information about their pension and retirement benefits.
  • Perform all transactional duties in relation to administering medical, dental, vision, life, flexible spending and retirement benefits.

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48. Financial Assistance

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low Demand
Here's how Financial Assistance is used in Benefits Representative jobs:
  • Interviewed Self Pay and under-insured patients to determine eligibility for State and federal financial assistance programs.
  • Facilitate and provide financial assistance for our patients with regard to treatment.
  • Educate patients on financial assistance programs and assist with application process.
  • Managed multiple accounts for past patients seeking financial assistance.
  • Interviewed patients to determine need for financial assistance.
  • Follow up on patient financial assistance status.
  • Conducted benefits trainings for partners * Processed employees' adoption-related financial assistance and allowance requests * Responsible for resolving non-standard eligibility inquires
  • Pre-qualified patients for financial assistance.
  • Assist patients in obtaining financial assistance (i.e.

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49. HSA

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low Demand
Here's how HSA is used in Benefits Representative jobs:
  • Administered HSA and healthcare and dependent care Flexible Spending Accounts for Ford Motor Company Salaried Active employees.

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50. Personal Information

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low Demand
Here's how Personal Information is used in Benefits Representative jobs:
  • Maintained and protected sensitive personal information.
  • Assisted military personnel with update of personal information in the Defense Eligibility Enrollment Reporting System (DEERS).
  • Process Change of Status forms, Benefit Enrollments, and personal information changes.
  • Created online system for employees to update their personal information.
  • Updated employee's benefits and personal information with vendors.
  • Processed human resource documents needed to obtain benefits and change personal information in Tesseract PayDay system.

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Benefits Representative Jobs

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20 Most Common Skills For A Benefits Representative

Customer Service

12.6%

Insurance Companies

12.2%

Benefits Administration

11.5%

COB

7.2%

Payroll Deductions

6.6%

Long-Term Disability

6.2%

Open Enrollment

6.2%

HR

4.2%

Fmla

4.0%

Providers

3.8%

Phone Calls

3.7%

Health Care

3.6%

Absence

2.7%

Data Entry

2.7%

Life Insurance Benefits

2.4%

Health Benefits

2.3%

Hipaa

2.1%

Welfare Plans

2.1%

Hris

2.0%

Medicaid

1.9%
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Typical Skill-Sets Required For A Benefits Representative

Rank Skill
1 Customer Service 9.7%
2 Insurance Companies 9.4%
3 Benefits Administration 8.9%
4 COB 5.6%
5 Payroll Deductions 5.1%
6 Long-Term Disability 4.8%
7 Open Enrollment 4.8%
8 HR 3.3%
9 Fmla 3.1%
10 Providers 2.9%
11 Phone Calls 2.8%
12 Health Care 2.8%
13 Absence 2.1%
14 Data Entry 2.1%
15 Life Insurance Benefits 1.9%
16 Health Benefits 1.8%
17 Hipaa 1.6%
18 Welfare Plans 1.6%
19 Hris 1.5%
20 Medicaid 1.5%
21 ADP 1.2%
22 Retirement Planning 1.1%
23 Pension Plans 1.1%
24 Insurance Plans 1.1%
25 Peoplesoft 1.0%
26 Special Projects 1.0%
27 Hippa 1.0%
28 Life Events 1.0%
29 FSA 1.0%
30 Outbound Calls 0.9%
31 Status Changes 0.9%
32 HMO 0.9%
33 New Clients 0.8%
34 Claims Issues 0.8%
35 Problem Resolution 0.8%
36 Medical Benefits 0.8%
37 STD 0.7%
38 High Volume 0.7%
39 Company Policies 0.6%
40 IRS 0.6%
41 Plan Participants 0.5%
42 Benefit Packages 0.5%
43 Erisa 0.5%
44 Confidential Information 0.5%
45 Plan Documents 0.5%
46 PPO 0.5%
47 Retirement Benefits 0.5%
48 Financial Assistance 0.5%
49 HSA 0.4%
50 Personal Information 0.4%
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4,042 Benefits Representative Jobs

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