What does a benefits representative do?
A benefits representative is responsible for facilitating and disseminating information about benefits programs and policies across all employees in the company. Benefits representatives respond to the employees' inquiries and concerns of benefits processes, update their benefits information, and resolve discrepancies and disputes. They also support the company's initiatives on developing new benefits plans, implementing campaigns, as well as writing application guides for reference. A benefits representative should have excellent communication and organizational skills as they also conduct surveys to check the efficiency and effectiveness of the benefits programs and adjusting procedures as needed.
Benefits representative responsibilities
Here are examples of responsibilities from real benefits representative resumes:
- Determine eligibility and process FMLA initial notification letters for employees which lead to immediate use of benefits.
- Service consumers inbound inquires via phone and live chat regarding HRA, FSA and HSA accounts.
- Work with clients to ensure ACA compliance.
- Train in and apply HIPAA privacy and security regulations and maintain strict confidentiality of claims.
- Contact any FSA or HRA groups concerning any outstanding payments for claims and/or admin fee invoices.
- Produce benefit-related reports from HRIS.
- Standardize processes and accommodate to HIPPA guidelines
- Maintain strict adherence to HIPAA and confidentiality requirements.
- Process FMLA paperwork determining employee eligibility period and send notifications to employee.
- Document and report inconsistencies to Medicaid and Medicare fraud and/or abuse of prescriptions.
- Subject matter expert on long term disability policy analysis and applicability of ERISA.
- Assist with securing benefits from Medicaid and charity programs including obtaining and completing all necessary eligibility documentation.
- Validate and maintain accurate information in HRIS PeopleSoft system and retrieve pertinent information retain for reporting and billing purposes.
- Collaborate with payroll to monitor benefit deductions and adjust premiums and arrears when necessary, guaranteeing accuracy in reporting W2 information.
- Assist veterans with obtaining documentation to support application for benefits and entitlements.
Benefits representative skills and personality traits
We calculated that 18% of Benefits Representatives are proficient in Customer Service, Patients, and Insurance Coverage. They’re also known for soft skills such as Analytical skills, Business skills, and Communication skills.
We break down the percentage of Benefits Representatives that have these skills listed on their resume here:
- Customer Service, 18%
Resolve customer service related issues via oral and written communications from members and clients while maintaining consistent quality and integrity.
- Patients, 18%
Prioritized Prior Authorization requests; assisted doctors' assistants and patients to obtain exceptions and appeals for non-covered prescriptions.
- Insurance Coverage, 8%
Qualified to answer employee questions regarding insurance coverage, educational reimbursement programs, pension and retirement plans and miscellaneous benefits.
- Medicaid, 6%
Educated and Enrolled potential members about the benefits of a Medicaid managed care organization over traditional fee-for-service Medicaid.
- Insurance Carriers, 5%
Communicated with union officials, insurance carriers, pharmacies and other medical professionals assure member coverage.
- Term Disability, 4%
Prepare short-term disability status report to payroll department on bi-weekly basis, meeting bi-weekly deadline.
"customer service," "patients," and "insurance coverage" are among the most common skills that benefits representatives use at work. You can find even more benefits representative responsibilities below, including:
Analytical skills. To carry out their duties, the most important skill for a benefits representative to have is analytical skills. Their role and responsibilities require that "compensation, benefits, and job analysis specialists perform data and cost analyses to evaluate their organization’s policies." Benefits representatives often use analytical skills in their day-to-day job, as shown by this real resume: "research and analyze claims issues ranging from routine to complex * review and process health claims. "
Business skills. Another soft skill that's essential for fulfilling benefits representative duties is business skills. The role rewards competence in this skill because "specialists must understand basic finance and accounting." According to a benefits representative resume, here's how benefits representatives can utilize business skills in their job responsibilities: "assist with annual open enrollment and monthly enrollment activities including systems testing, employee presentations, and hr business partner communications. "
Communication skills. This is an important skill for benefits representatives to perform their duties. For an example of how benefits representative responsibilities depend on this skill, consider that "specialists need to provide information about compensation and benefits in a way that is understandable to employees at all levels throughout their organization." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of a benefits representative: "administer short-term disability and fmla claims, including call, questions and on-going communications with our outside insurance company. ".
The three companies that hire the most benefits representatives are:
- Centene39 benefits representatives jobs
- US Oncology Holdings Inc27 benefits representatives jobs
- CVS Health11 benefits representatives jobs
Choose from 10+ customizable benefits representative resume templates
Build a professional benefits representative resume in minutes. Our AI resume writing assistant will guide you through every step of the process, and you can choose from 10+ resume templates to create your benefits representative resume.
Compare different benefits representatives
Benefits representative vs. Workers compensation coordinator
Workers compensation coordinators work with supervisors to identify incident causes and the best corrective actions. They train coordinators and supervisors on reporting and managing workers' compensation claims. Besides coordinating EHS committee meetings and managing EHS files, workers' compensation coordinators also manage workers' programs for hearing tests, safety glasses, and safety shoes. These professionals use the company credit card or purchasing system to order safety supplies. Also, they ensure workers get the needed care by partnering with medical providers and injured employees.
These skill sets are where the common ground ends though. The responsibilities of a benefits representative are more likely to require skills like "customer service," "insurance coverage," "term disability," and "health insurance." On the other hand, a job as a workers compensation coordinator requires skills like "osha," "excellent planning," "rehabilitation," and "data entry." As you can see, what employees do in each career varies considerably.
Workerss compensation coordinator earn the highest salaries when working in the finance industry, with an average yearly salary of $67,433. On the other hand, benefits representatives are paid more in the finance industry with an average salary of $41,460.The education levels that workerss compensation coordinator earn slightly differ from benefits representatives. In particular, workerss compensation coordinator are 2.6% more likely to graduate with a Master's Degree than a benefits representative. Additionally, they're 0.3% more likely to earn a Doctoral Degree.Benefits representative vs. Compensation analyst
Compensation analysts are responsible for managing company compensation programs by evaluating and analyzing employees' salaries, assist the planning and development of a new and modified sales compensation plan, as well as managing sales compensation short-term incentive programs. The compensation programs are used to improve hiring and boost employee retention. These analysts are skilled and knowledgeable about managing labor costs, benefits structures, and compensation analysis to determine if the employees are fairly compensated.
In addition to the difference in salary, there are some other key differences worth noting. For example, benefits representative responsibilities are more likely to require skills like "patients," "insurance coverage," "medicaid," and "insurance carriers." Meanwhile, a compensation analyst has duties that require skills in areas such as "compensation programs," "powerpoint," "data analysis," and "flsa." These differences highlight just how different the day-to-day in each role looks.
Compensation analysts earn a higher average salary than benefits representatives. But compensation analysts earn the highest pay in the technology industry, with an average salary of $77,218. Additionally, benefits representatives earn the highest salaries in the finance with average pay of $41,460 annually.Average education levels between the two professions vary. Compensation analysts tend to reach higher levels of education than benefits representatives. In fact, they're 10.5% more likely to graduate with a Master's Degree and 0.3% more likely to earn a Doctoral Degree.Benefits representative vs. Provider enrollment specialist
A provider enrollment specialist is in charge of handling application procedures in a company or facility. Their responsibilities typically revolve around gathering information, reviewing and verifying requirements, processing applications, and liaising with clients. They may also maintain and update databases, assist during complicated procedures, and ensure that all requirements are complete and accurate. Furthermore, as a provider enrollment specialist, it is essential to discuss terms and conditions to clients, helping them understand the company's policies and regulations, including its vision and mission.
Some important key differences between the two careers include a few of the skills necessary to fulfill the responsibilities of each. Some examples from benefits representative resumes include skills like "customer service," "insurance coverage," "term disability," and "health insurance," whereas a provider enrollment specialist is more likely to list skills in "data entry," "caqh," "medicare," and "provider enrollment applications. "
Provider enrollment specialists make a very good living in the technology industry with an average annual salary of $42,041. On the other hand, benefits representatives are paid the highest salary in the finance industry, with average annual pay of $41,460.When it comes to education, provider enrollment specialists tend to earn similar degree levels compared to benefits representatives. In fact, they're 0.2% less likely to earn a Master's Degree, and 0.3% less likely to graduate with a Doctoral Degree.Benefits representative vs. Verification specialist
The verification specialist's primary role is to make and take calls to employers for the purpose of verifying information stated by an applicant on his/her /her job application. They manage calls inbound/outbound for education, employment, reference, and licensing verification purposes. They also maintain and keep records of all calls handled to ensure all verifications made are followed upon on time. They communicate effectively and proficiently to all parties involved in attaining verification information. Moreover, they do monthly review to quality check all data gathered for verifications.
Types of benefits representative
Updated January 8, 2025
