Health Benefits Officer II

Description

The American Foreign Service Protective Association (AFSPA) is seeking detail-oriented, service-driven professionals to support members navigating Foreign Service Benefit Plan (FSBP) health benefits, claims, medical/pharmacy coverage, and eligibility issues. This essential role supporting a mission-driven membership organization is ideal for individuals who excel in structured, policy-driven environments, enjoy problem-solving, and take pride in delivering accurate, high-quality, and compassionate service.

This position is not a sales or advisory role. It requires strict adherence to documented health plan benefits, regulatory requirements, and internal procedures.

Please apply directly to our company site by copying and pasting the following URL into your web browser:

https://talent.paylocity.com/Talent/Jobs/Details/4233606

Key Responsibilities include, but are not limited to the following:

• Answer high-volume inbound calls in a call center environment.
• Assist members with health benefits, claims, eligibility, and coverage inquiries via phone, email, and written correspondence.
• Troubleshoot issues, de-escalate member concerns, and resolve inquiries in alignment with regulatory and plan guidelines.
• Review claims for accuracy and completeness, and document all member interactions in Customer Relationship Management (CRM) systems in real-time.
• Collaborate with plan administrators and escalate issues to supervisors as needed.
• Ensure compliance with healthcare regulations, policies, and procedures.

Salary Range: $44,000 – $50,000, annually based on a 35-hour work week (commensurate with education and experience).

$500 signing bonus after the successful completion of the first 90 days.

Benefits: Comprehensive medical, dental, and vision coverage, retirement plan (401k), paid time off, and paid holidays.

AFSPA offers hybrid/remote work options based on business needs. At any time, you'll need to be in the office up to 4 days per week, based on business need. Note: This position is fully remote, scheduled Monday through Friday from 11:00 AM to 7:00 PM EST, following completion of initial training. Candidates must have access to a workspace that supports reliable internet connectivity and protects the privacy of sensitive client data. The company provides necessary computing hardware and a monthly remote work stipend to support technical connectivity needs

AFSPA is a federal contractor and an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, and gender identity), national origin, age, disability, genetic information, protected veteran status, or any other legally protected status.

Employment may be contingent upon the successful completion of a background check, drug test, or other pre-employment screenings, as required by law or policy.

Requirements

Education and Experience:

• High school diploma or equivalent required
• 3+ years of customer service experience required (in a call center, benefits, or healthcare environment preferred)

Qualifications:

• Experience with health insurance, medical claims, or benefits administration is a plus.
• You are highly organized, detail-oriented, with excellent problem-solving abilities, and comfortable working with and following documented policies and procedures.
• You can remain professional and calm under pressure.
• You can manage high-volume inbound calls while maintaining professionalism and empathy.
• You are comfortable learning multiple systems and passing structured training assessments.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Training & Performance Expectations

90-day paid, structured training program with required assessments covering:

1. Health Plan Brochure (open-book assessment)
2. Systems training across multiple databases/platforms
3. Live call handling / Telephone operations

This is an essential position with consistent performance expectations. Candidates must achieve 85% or higher on all training assessments to successfully complete the program and maintain employment with AFSPA.

Work Location:

The following are work locations that AFSPA utilizes: New Carrollton, Maryland, Satellite Office; Washington, DC Headquarters; and remote. Remote work is not guaranteed and is based on business need. Work location will be assigned and/or changed based upon business need and at Management’s sole discretion.