Benefit Specialist; Troy, MI

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Summary – The Benefit Specialist serves as a knowledgeable and resourceful benefits expert, empowering members to navigate their plans with confidence and ease. Actively listen to inquiries, research, and resolve complex issues, and provide accurate and timely information while ensuring efficient data management. Utilize strong analytical and problem‑solving skills to make using their benefits easier for members and to streamline communication with Bene Sys, fostering positive relationships and improving overall member satisfaction.

• Provide exceptional member support via phone calls, walk‑ins, and emails related to eligibility and claims.
• Assist members in navigating their healthcare benefits effectively by resolving inquiries and addressing concerns as the Bene Sys primary point of contact.
• Deliver accurate and timely information to members regarding their healthcare benefits through active listening and effective communication.
• Utilize strong analytical and problem‑solving skills to research and resolve complex healthcare inquiries.
• Communicate with vendors on behalf of the member regarding prior authorizations, claims, and eligibility issues.
• Facilitate communication between members and the Retirement Services Department for all pension and retirement related questions.

• Process enrollments, self‑payments, and month‑end eligibility updates.
• Ensure accurate enrollment processing by collecting enrollment forms and adding members and dependents to systems and verifying documentation.
• Maintain member data integrity by updating records, auditing vendor files, and resolving discrepancies.
• Streamline benefit access by preparing enrollment packages, issuing , and notifying members of COBRA qualifying events.
• Possess a thorough understanding of plan rules outlined in the Summary Plan Description to answer member inquiries accurately and provide informed guidance regarding eligibility, claims, and benefits.

• Collaborate with the Client Liaison and Enrollment Processor to ensure smooth administrative workflows.
• Visit Union Hall weekly to support member walk‑ins and provide in‑person assistance.
• Assist with incoming mail and enrollment documentation as needed.
• Participate in client‑sponsored events to provide direct benefit guidance.

• Experience in a fast‑paced call center environment with proven ability to handle high call volume and prioritize tasks effectively.
• Demonstrated success in resolving inquiries and complaints while exceeding customer satisfaction standards.
• Strong communication skills both written and verbal, with the ability to convey complex information clearly and concisely to diverse audiences.
• Ability to learn and work efficiently in multiple systems and applications.
• Empathy and active listening skills to understand member concerns and provide reassurance and emotional support.
• Proven ability to build rapport and establish trust with members, creating positive relationships.
• Strong communication and interpersonal skills.
• Problem‑solving and analytical abilities.
• Excellent research and investigative skills.
• Proficiency in healthcare terminology and insurance policies.
• A passion for advocating for others and making a difference.
• Regular and predictable attendance is an essential function of this job.

• Healthcare Knowledge:
  Familiarity with basic medical terminology, types of health insurance plans, claim processes, and relevant healthcare regulations can significantly enhance your ability to assist members.
• Technical
  
  Skills:
  
  Proficiency in customer relationship management (CRM) software, data entry, and other relevant computer programs may be required.
• Experience in a customer service role, ideally within the healthcare industry.
• Experience handling complex claims issues or working with diverse populations.
• Bilingual skills to support a diverse member base.