Employee Benefits Claims Advisor

The Employee Benefits Claims Advisor advises and resolve the most complex benefit claim issues by managing incoming and outbound calls and emails, collaborating with insurance carriers, providers, and third party administrators to resolve claim and eligibility concerns for client members. This role is a SME (Subject Matter Expert) in claims.

The Ideal Candidate

• You are a seasoned claims professional who has a customer service mindset & can solve complex claims issues
• Analytical at heart, you are a true fact finder and are detail oriented
• You are a true team player who isn’t afraid to roll up their sleeves with the rest of the team

If this sounds like you, we invite you to keep reading and apply!

• Resolves the most complex benefit claim issues by managing incoming and outbound calls and emails, collaborating with insurance carriers, providers, and third party administrators to resolve claim and eligibility concerns for client members.
• Responds to and educates client members about their health and welfare benefits.
• Develops professional and trusting relationships with client members, responding accurately to benefit questions, providing claim resolution expertise and any other assistance and/or support requested or required by the client.
• Meets HIPAA Privacy Rules by maintaining the highest level of confidentiality and complying with all applicable laws, Advocating and negotiating on behalf of the client members as necessary to assist with eligibility, claim and benefit issues or any question or concern.
• Maintaining clear and accurate records and updating open issues by logging into a secure database.

Required: High School diploma or equivalent; Minimum 3-5 years related claims experience. Current Life, Accident & Health Resident State Insurance License or ability to successfully obtain license within 3 months of hire date. Ability to work overtime as business need requires. Exceptional customer service skills with a strong knowledge of carrier claims processing and billing procedures. Working knowledge of Microsoft Windows applications and Microsoft Office.

Preferred: Bachelors degree preferred. Prior customer service and/or employee benefits experience highly desirable. Experience with CRM software (e.g. Salesforce) is beneficial.

Behaviors: Excellent organizational skills, with emphasis on priorities and goal setting. Ability to communicate information, whether technical or non-technical to client members/customers in a clear and concise manner.

We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. 

Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve:

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave

Other benefits include:

• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...

**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.

We value inclusion and diversity

Click Here to review our U.S. Eligibility Requirements

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.

Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.

Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.

Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.