Benefits Specialist

Why is Health Advocate a great place to work? For starters, Health Advocate employees enjoy helping people every single day. Employees are given the training they need to do their jobs well, and they work with supervisors and staff who are supportive and friendly. Employees have room to grow, and many of Health Advocate's supervisors are promoted from within the company.  Join our award winning team!

2025:

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2024:

• Excellence in Customer Service Awards: Organization of the Year (Small)

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

As part of Teleperformance in the US, we were also named #95 in the 2024 ‘Fortune 100 Best Companies to Work For®’ in the USA by Great Places to Work (GPTW®)

Basic Function

Responsible for interfacing with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors and detailed benefit review; answer incoming calls and respond to benefit inquires; place outbound follow-up calls for issues that cannot be resolved during the initial call; provide guidance to members on open enrollment issues, questions and concerns about benefit options which may include comparing and contrasting benefits during open enrollment, new hires and change of status

Major Job Accountabilities

Benefits Functions – Interface with internal and external resources to provide guidance and direction regarding benefit plan options, cost factors, and detailed benefit review ensuring adherence to department and corporate policies and procedures.

• Answer incoming calls/cases and respond to member benefit inquires, cases and calls assigned by supervisor and place outbound calls and/or contacts to members for calls and cases that cannot be resolved during the initial call
• Provide objective information to members on open enrollment issues, questions, and concerns about benefit options, which may include comparing and contrasting benefits during open enrollment, new hire election period and change of status
• Connect with members by phone and quickly develop a rapport to help the individual to navigate their benefit choices and options
• Answer members’ questions related to benefit plans (i.e., medical, dental, pharmacy, vision, life, STD, LTD, and other benefits) consumer driven health plans, FSAs, provider selection, qualifying life events, open enrollment, and estimated cost of care
• Review plan options and costs for members considering individual health insurance plans, Marketplace/exchange plans, COBRA, and Medicare plans
• Exercise exceptional customer service skills to optimize each contact with the member
• Ensure that calls are processed in strict adherence to established policies, procedures, quality standards as well as applicable federal laws and regulations
• Know and support approved departmental and corporate policies and procedures
• Follow policies and procedures to remain in compliance with all applicable laws and regulations, including the privacy of employee health information in compliance with federal and state laws such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Affordable Care Act, and other legislation
• Resolve benefit issues by identifying issue(s) and researching in a timely manner ensuring adherence to department and corporate policies and procedures
• Follow research through until resolution is reached for member
• Document all benefit issues thoroughly, maintaining department files and appropriate systems
• Continuously evaluate the status of all work efforts, ensuring all tasks are prioritized to assist in providing timely and quality services
• Assist in monitoring issue trends, escalating such trends to supervisor to determine appropriate actions necessary to eliminate future occurrences and improve service levels
• Maintain strict confidentiality of information provided by customer or data accessed within assigned systems

Team Interfaces/Customer Service - Establish and maintain a professional relationship with internal/external customers, team members and department contacts

• Cooperate with team members to meet goals or to complete tasks
• Provide quality customer service that exceeds customer expectations and improves level of service being provided
• Treat all internal/external customers, team members, and department contacts with dignity/respect
• Escalate to supervisor any situation outside the employee's control that could adversely impact the services being provided

Mental and Physical Requirements

• This position will be exposed mainly to an indoor office environment and will be expected to work near or around computers, telephones, and printers 
• The nature of the work in this position is sedentary and the incumbent will be sitting most of the time.
• Essential physical functions of the job include fingering, grasping, pulling hand over hand, and repetitive motions to utilize general computer software/hardware continuously throughout the work day
• Essential mental functions of this position include concentrating on tasks, reading information, and verbal/written communication to others continuously throughout the work day

Related Duties as Assigned -

• The job description documents the general nature and level of work but is not intended to be a comprehensive list of all activities, duties, and responsibilities required of job incumbents
• Consequently, job incumbents may be asked to perform other duties as required
• Also note, that reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above
• Please contact your local Employee Relations representative to request a review of any such accommodations

Minimum Qualifications

Applicant for this job will be expected to meet the following minimum qualifications.

Education

• High School Degree or GED required
• Associate’s degree from an accredited college or university with major course work in business administration, liberal arts, public health, healthcare management, or a related field preferred

Experience

• Minimum of one to two years customer service
• Minimum of one to two years benefits experience

Other

• Basic knowledge of MS Word and Excel required
• Must score acceptably on job related testing
• Ability to pass standardized interview
• Based on assignment may need to be bilingual in English, Spanish, etc.

Knowledge of the following is preferred:

• COBRA
• Medicare A, B, MediGap, Supplement plans, Medicare Advantage, Medicare Part D plans
• High deductible health plans including Health Reimbursement Accounts (HRAs) and Health Saving Accounts (HSAs)
• Flex Spending Accounts (FSA) , including limited FSAs
• Coordination of benefits and which plan is primary – simple cases (commercial plans, Medicare plans)
• Summary Plan Documents (SPDs) and Certificates of Coverage (COCs)
• Government programs, resources and legislation and mandates including but not limited to Affordable Care Act, FMLA, Medicaid, CHIP
• Group Health Plans (fully insured and self-insured)
• Pharmacy benefits including injectable medications
• Individual Health Plans and Marketplace/Exchanges plans

A successful incumbent in the job will be able to demonstrate the following skills and abilities:

• Strong communication skills and phone etiquette
• Ability to explain complex issues to members
• Highly effective listening skills
• Strong problems solving/issue resolution skills
• Excellent customer service and customer resolution skills
• Strong Organizational and administrative skills
• Ability to work in a team environment

Join Us as a Benefits Specialist

At Health Advocate, we’re dedicated to simplifying healthcare and empowering individuals to make informed benefits decisions. We don’t just provide answers—we create solutions. If you’re passionate about helping others, providing exceptional service, and making a real impact, this is your opportunity to be part of something bigger.

What You’ll Do: Your Roadmap to Impact

This isn’t just about answering questions—it’s about guiding individuals through their benefits with clarity and confidence. Here’s how you’ll make a difference every day:

• Be a Trusted Advisor: Answer incoming calls and assist members with their benefit inquiries, providing objective information about plan options, costs, and coverage details.
• Support Open Enrollment: Guide members through benefit elections during open enrollment, new hire periods, and life status changes, ensuring they understand their options.
• Provide Expert Insights: Explain medical, dental, vision, pharmacy, life insurance, disability, and other benefit plans, along with COBRA, Medicare, and Marketplace plans.
• Navigate Complex Benefit Issues: Research, analyze, and resolve benefit-related concerns while maintaining compliance with corporate policies and federal regulations.
• Ensure Accuracy & Compliance: Document all benefit interactions thoroughly, maintain confidentiality, and adhere to HIPAA, COBRA, ACA, and other applicable laws.
• Champion Customer Experience: Exercise exceptional customer service skills to create positive member experiences and foster trust.

Who You Are: The Benefits Guide We’re Looking For

We’re seeking a knowledgeable and service-driven professional who thrives on problem-solving and clear communication. If you bring the following qualities, we’d love to meet you:

• Experience That Counts: At least one to two years of customer service and benefits experience.
• Benefits-Savvy & Detail-Oriented: Familiarity with COBRA, Medicare, HSAs, FSAs, and group health plans is preferred.
• Strong Communicator: You have excellent verbal and written communication skills and can explain complex benefit details clearly and effectively.
• Tech-Savvy & Organized: You’re comfortable using MS Word, Excel, and internal systems to research and document information.
• Service-Oriented & Team-Driven: You thrive in a collaborative environment and are dedicated to providing top-tier service.

Why Health Advocate?

At Health Advocate, we don’t just support our members—we support you. Here’s what you’ll get:

• ✅ Comprehensive Training & Equipment: We set you up for success with thorough onboarding, ongoing development, and all necessary work tools.
• ✅ Career Growth & Development: We provide mentorship, training, and opportunities for advancement.
• ✅ Competitive Pay & Benefits: Robust medical, dental, vision, tuition assistance, a 401(k) with company match, PTO, and paid holidays.
• ✅ A Culture of Purpose & Impact: Join a team that values empathy, innovation, and a shared mission to simplify benefits for all.

Your Next Move

Are you ready to make a difference and become a trusted advocate for those navigating their healthcare benefits? Apply today and take the first step toward joining a team that believes in the power of compassion, knowledge, and service.

Gallup Strengths Quadrants for Success in This Role

To excel as a Benefits Specialist, candidates need strengths across three key Gallup quadrants:

Relationship Building – Crucial for establishing trust and guiding members through sensitive benefits decisions.

• Key Strengths: Empathy, Adaptability, Connectedness, Communication

Executing – Essential for managing multiple inquiries, following through on research, and ensuring accuracy in every interaction.

• Key Strengths: Responsibility, Discipline, Achiever, Focus

Strategic Thinking – Needed to analyze benefit options, understand regulations, and provide informed guidance.

• Key Strengths: Analytical, Learner, Input, Intellection

5 Screening Questions to Hire the Best Fit

To identify candidates who have the skills, mindset, and strengths to succeed in this role, use these targeted screening questions:

Relationship Building – Handling Member Interactions
"Tell me about a time when you had to explain a complex benefit option to someone who was confused. How did you handle the situation, and what was the outcome?"

• What it assesses: Empathy, patience, and ability to simplify information for others.

Executing – Managing Workload & Accuracy
"This role requires handling multiple benefit inquiries while ensuring accuracy. How do you stay organized and prioritize tasks effectively?"

• What it assesses: Time management, attention to detail, and ability to meet service expectations.

Strategic Thinking – Problem Solving & Benefits Knowledge
"A member calls in unsure about which health plan best fits their needs. How would you guide them through the selection process?"

• What it assesses: Analytical thinking, knowledge of benefits, and ability to personalize solutions.

Tech-Savviness & Adaptability
"Tell me about a time you had to quickly learn a new benefits system or process. How did you approach the learning process?"

• What it assesses: Comfort with technology, adaptability, and willingness to learn.

Follow-Through & Customer Commitment
"Can you share an example of a time you had to resolve a benefit-related issue for a member? How did you ensure accuracy and follow-through?"

• What it assesses: Accountability, follow-through, and ability to provide excellent service.

Physical Requirements:
This position is primarily sedentary, requiring prolonged sitting while performing administrative tasks. The role involves extensive use of a computer for typing, mouse navigation, and reading information on a screen for extended periods. Frequent phone use is required for communication with team members, clients, or external parties. Essential physical functions include fingering, grasping, pulling hand-over-hand, and repetitive motions necessary for navigating software, entering data, and interacting with electronic documents.

Mental and Cognitive Requirements:
The role requires strong concentration, attention to detail, and the ability to complete tasks accurately. Critical thinking and problem-solving skills are essential to address issues that may arise in day-to-day duties. Effective verbal and written communication skills are needed for responding to inquiries and collaborating with others.

Work Environment:
This position is fully remote and requires a home office environment with appropriate lighting, a computer, and phone access. The workspace should be free from distractions to ensure effective focus and productivity during work hours.

Company Overview

Health Advocate is the nation’s leading provider of health advocacy, navigation, well-being and integrated benefits programs. For 20 years, Health Advocate has provided expert support to help our members navigate the complexities of healthcare and achieve the best possible health and well-being. Our solutions leverage a unique combination of best-in-class, personalized support with powerful predictive data analytics and a proprietary technology platform to address nearly every clinical, administrative, wellness or behavioral health need. Whether facing common issues or an unprecedented challenge like COVID-19, our team of highly trained, compassionate experts work together to go above and beyond expectations, making healthcare easier for our members and ensuring they get the care they need.

Learn more

Health Advocate https://www.healthadvocate.com/site/

Facebook https://www.facebook.com/healthadvocateinc/

Video https://vimeo.com/386733264/eb447da080

Awards:

2025:

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2024:

• Excellence in Customer Service Awards: Organization of the Year (Small)

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2023:

• National Customer Service Association All-Stars Award: Service Organization of the Year.

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

2022:

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Bronze Winner

• Excellence in Customer Service Awards: Organization of the Year (Small)

• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2021:

• Stevie® Awards for Sales & Customer Service: Customer Service Department of the Year – Healthcare, Pharmaceuticals, and Related Industries, Silver Winner

• Stevie® Awards for Sales & Customer Service: Most Valuable Response by a Customer Service Team (COVID-19). Bronze Winner

• Best in Biz Awards: Most Customer-Friendly Company of the Year – Medium and large category (Silver)

2020:

• National Customer Service Association All-Stars Award: Organizations of 100 or Greater, Runner-Up

• Communicator Award of Distinction: October 2019 Broker News

• MarCom Awards: Gold, COVID Staycation Ideas brochure

• MarCom Awards: Platinum, 2021 Well-being Calendar

• Best in Biz Awards: Most Customer-Friendly Company of the Year - Medium category (Silver)

VEVRAA Federal Contractor requesting appropriate employment service delivery systems, such as state workforce agencies and local employment delivery systems, to provide priority referrals of protected veterans.

PAY TRANSPARENCY NONDISCRIMINATION PROVISION

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-I.35(c)