Benefits Resource Representative

Position Information

Job Title: Benefits Resource Representative
Department: Operations
Reports To: Team Manager / Operations Manager
Location: Remote – Jamaica
Employment Type: Full-Time

Scope: Phone Based

Job Summary

The Benefits Resource Representative assists individuals with enrolling in insurance coverage by providing clear information, answering questions, and guiding members through the application and enrollment process. This role serves as a key point of contact for customers seeking assistance with understanding available insurance options, eligibility requirements, and completing enrollment documentation.

The representative will interact with members through inbound and outbound calls, and internal systems to ensure accurate enrollment processing and a positive customer experience. This role requires strong communication skills, attention to detail, and the ability to navigate multiple systems while maintaining professionalism and compliance with insurance guidelines and company policies.

Work Schedule

• Schedule: Monday to Friday, standard business hours (8AM-5PM)
• Time Zone: Must be able to work aligned with U.S. operational time zones (EST preferred)
• Flexibility: May be required during peak enrollment or open enrollment periods

Essential Job Functions

(Listed in order of importance with approximate % of time. Total equals 100%.)

Insurance Enrollment Assistance – Guide individuals through the insurance enrollment process by explaining available coverage options, eligibility requirements, and necessary documentation.

30%

Inbound & Outbound Member Support – Respond to member inquiries via phone, or messaging platforms regarding enrollment status, coverage details, and program information.

25%

Application Processing & Documentation Review – Assist with completing enrollment forms, reviewing submitted documentation for accuracy, and ensuring all required information is properly captured.

20%

System Navigation & Data Entry – Enter and maintain accurate records within CRM, enrollment platforms, and internal databases.

10%

Compliance & Policy Adherence – Ensure all enrollment activities comply with insurance regulations, program guidelines, and company procedures.

10%

Customer Experience & Issue Resolution – Provide professional and empathetic support while addressing concerns, resolving issues, or escalating complex cases when necessary.

5%

Required Qualifications (Knowledge, Skills & Experience)

• Minimum 1–2 years of experience in customer service, healthcare support, insurance support, in the call center environments.
• Strong verbal and written communication skills with a professional phone presence.
• Ability to explain complex information clearly and patiently to customers.
• Strong attention to detail when reviewing forms and documentation.
• Comfortable working with multiple systems and platforms simultaneously.
• Ability to handle sensitive information with confidentiality and professionalism.
• Strong organizational skills and the ability to manage multiple tasks in a fast-paced environment.

Preferred Qualifications

• Previous experience in Insurance Enrollment, Benefits Administration, or similar programs.
• Experience working in a BPO or remote support environment.
• Familiarity with CRM systems, case management systems, or enrollment platforms.
• Experience supporting U.S.-based clients or customers.

Work Conditions / Physical Demands / Travel Requirements

This position operates in a fully remote environment and requires:

• Quiet, professional workspace suitable for customer calls
• Reliable high-speed internet connection
• Laptop or desktop computer with functioning camera
• Having an additional monitor
• Wired noise-canceling headset
• Ability to remain seated and work on a computer for extended periods

Travel is not required.

Important Notes

• This role may involve high call volumes during enrollment periods.
• Representatives must maintain professionalism, empathy, and accuracy when assisting members.
• Employees are expected to strictly adhere to data privacy, confidentiality, and compliance standards.
• Responsibilities may evolve based on program needs or operational changes.

Disclaimer

This job description outlines the general nature and level of work performed and is not intended to be an exhaustive list of duties or responsibilities. Duties may be adjusted to meet business needs.

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