The Accident & Sickness Representative provides customer service to participants, beneficiaries, union locals, regarding eligibility, benefits, and claims status.
"Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."
Key Duties and Responsibilities- Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions.
- Provides verbal and/or in person customer service, responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
- Updates files, including documenting system notes of conversations or action taken.
- Performs tasks associated with the administration of health and welfare benefits such as;
- sending required forms as requested by members.
- Initiates Action Requests to department requesting stop pay, return to work, address change as necessary. Follows up to ensure successful completion of Action Request.
- Researches and resolves complex calls.
- Performs other duties as assigned.
- High school diploma or GED.
- Six months of experience working in customer service, third-party administrator processing, or benefits administration.
- Strong work ethic and team player mentality.
- Highly developed sense of integrity and commitment to customer satisfaction.
- Ability to communicate clearly and professionally, both verbally and in writing.
- Solid organization skills with strong detail orientation and listening skills.
- Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
- Proficient computer skills including MS Office tools and applications.
Preferred Qualifications
- Call center experience in benefits claims and multiple funds.
- Bilingual a plus.
*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee of this job. Duties, responsibilities and activities may change at any time with or without notice.
Working Conditions/Physical Effort- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at times.
Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law, it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact the Recruiting Department at [email protected], and we would be happy to assist you.
Please note that in compliance with certain state law, we are displaying salary. This rate is intended for hires into this location.
Compensation: $19.00/hr
Zenith American Solutions
Real People. Real Solutions. National Reach. Local Expertise.
We are currently looking for a dedicated, energetic employee with the necessary skills, initiative, and personality, along with the desire to get the most out of their working life, to help us be our best every day.
Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources, best practices and scale, the new organization is even stronger and better than before.
We believe the best way to realize our better systems for better service philosophy is to hire the best employees. We're always looking for talented individuals who share our dedication to high-quality work, exceptional service and mutual respect. If you're interested in working in an environment where people - employees and clients - really matter, consider bringing your talents to Zenith American!
We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package, we offer an array of benefits including health, vision, and dental coverage, a retirement savings 401(k) plan with company match, paid time off (PTO), great opportunities for growth, and much, much more!
Skills Required
- High school diploma or GED
- At least six months of experience in customer service, third-party administrator processing, or benefits administration
- Strong work ethic and ability to work as part of a team
- Integrity and commitment to customer satisfaction
- Clear and professional verbal and written communication skills
- Organization, attention to detail, and listening skills
- Ability to read, analyze, and interpret business materials, technical procedures, benefit plans, and regulations
- Proficiency with MS Office tools and applications
- Call center experience in benefits claims and multiple funds
- Bilingual ability
What We Do
Zenith American Solutions’ mission is to compassionately care for America’s Workforce so that they can live more secure, productive, and healthy lives. As the largest independent Third Party Administrator in the United States, we have the depth and breadth of people, services and technology to provide custom plan solutions and local personal service for our clients and their members.
