Member Support Specialist | Employee Benefits

Description

The Member Support Specialist is responsible for delivering high-quality service to members by addressing questions related to benefits, eligibility and medical claims.  This role serves as a primary point of contact for member inquiries, working closely with providers, carriers and internal team members to resolve issues efficiently and accurately. The ideal candidate demonstrates strong communication skills, attention to detail and the ability to problem-solve in a fast-paced environment.

Work Performed:

• Handle inbound customer service calls regarding employer-sponsored benefit plans
• Review and investigate medical claims, coordinating with providers and carriers to ensure accurate processing and resolution of discrepancies
• Communicate benefit eligibility and explain plan provisions based on plan documents
• Assist members in understanding benefit options and navigating their coverage
• Conduct outreach to providers, clients and carriers as needed to support issue resolution
• Document and maintain accurate call notes and activity in the tracking system
• Utilize internal systems and databases to provide timely and accurate information
• Manage time effectively while maintaining attention to detail and service quality
• Handle challenging member interactions with professionalism and escalate issues when appropriate
• Collaborate with team members to resolve complex issues and support departmental needs
• Support enrollment activities, including handling enrollment calls and assisting during peak periods such as Open Enrollment
• Participate in additional projects and tasks within the Benefits department as needed
• Build and maintain positive, professional relationships with members, coworkers and external partners

Requirements

• Ability to obtain a Life & Health Insurance License within 90 days of hire
• Strong communication skills with a customer-first mindset and professional phone etiquette
• Ability to troubleshoot issues with empathy, patience and critical thinking
• Detail oriented with strong organizational and time management skills
• Comfortable working in a fast-paced, team-oriented environment
• Basic technical aptitude and ability to navigate multiple systems and databases

Preferred Education & Experience

• Prior experience in customer service, benefits administration or healthcare-related support
• Bilingual in Spanish (preferred, but not required)

Summary

Deeply Rooted to Serve

Oakbridge Insurance Agency is a new kind of insurance and risk management agency with the mission to transform and elevate the way business is done in our industry.

For over 100 years, the founding firms of Oakbridge worked alongside each other in small towns and cities throughout the Southeast, cultivating similar company cultures and best practices, and earning each other's respect in the industry. They envisioned a way to impact the future of insurance and formed Oakbridge Insurance Agency on January 1, 2021. Since forging this different path, we are proud to have added additional partners to Oakbridge who reflect our vision, demonstrate our core values, and share our commitment to doing what is right for our friends and neighbors.

Our most important asset is our people. We offer a friendly and flexible work environment and offer first-class benefits to meet the needs of you and your family. Benefits include a 401k plan with immediate participation, company match, and immediate 100% vesting. Company-paid benefits include life insurance and short- and long-term disability. We have a strong health insurance plan and many supplemental, voluntary offerings.

Oakbridge Insurance is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. Oakbridge Insurance makes hiring decisions based solely on qualifications, merit, and business needs at the time.

For more information visit our website:

Deeply Rooted Insurance Agency | Oakbridge Insurance - Oakbridge Insurance