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The Judge Group · 1 day ago

Benefits Specialist

Philadelphia, PA

Contract

Onsite

Mid Level

3+ years exp

The Judge Group is seeking a highly detail-oriented and analytical professional to join their team as a Benefits Incident Resolution Specialist. This role serves as a critical liaison between the business and multiple departments, ensuring timely and accurate resolution of benefit-related incidents across all lines of business and market segments.

E-LearningInformation TechnologyProfessional Services

Hiring Manager

Jacob Maybrier

Responsibilities

Act as the primary liaison for benefit-related tickets submitted by Customer Service, Operations, Claims, Sales, Member Appeals, and Executive inquiries

Review incidents for all lines of business, including Fully Insured and Self-Funded market segments

Ensure incidents are resolved within established internal SLA timelines

Conduct research across various source applications for client, product, and benefits setup

Utilize applications such as FOS, CSIW, Health Rules Payor, and Product Configurator for benefit analysis

Prepare detailed supporting documentation and written responses for key, critical, and highly visible customers

Facilitate cross-departmental discussions to ensure alignment on rules and benefit setup

Qualification

Health insurance claims processingAnalytical skillsMicrosoft Office SuiteCommunication skillsManage prioritiesDetail-orientedOrganizational skillsWritten communicationVerbal communication