Description
Summary:
This role supports clients and members by responding to inquiries, resolving concerns, and maintaining accurate employee benefit data for various benefit programs.
Highlights:
1. Coordinate administration of employee benefit programs and advise employees
2. Serve as point of contact for designated clients, providing customer service
3. Process enrollment, changes, claims, and assist with reporting and renewals
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Introduction
At Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they’re free to grow, lead, and innovate. You’ll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you’re not just improving clients' risk profiles, you’re building trust. You’ll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you’re ready to bring your unique perspective to a place where your work truly matters; think of Gallagher.
Overview
RPA San Diego, a subsidiary of Gallagher, operates as a third-party administration (TPA), consulting, and strategic management branch for collectively bargained benefit plans, pooled purchasing arrangements, and trusts. Our mission is to deliver high quality, affordable, and accessible health care to our members.
The Client Benefits Administrator is responsible for supporting clients and/or members by responding to inquiries, resolving concerns, and maintaining accurate employee benefit data.
How you'll make an impact
Coordinates the administration of employee benefit programs such as basic and major medical coverage, dental insurance, group life insurance, pension plans, and other benefits for the client.
Consults with and advises employees on eligibility, provisions, and other matters related to benefits.
Maintains benefits records and documents.
Assists in the preparation of employee benefits booklets and other employee benefit communications.
Works within specific limits and authority on assignments that are routine and of low to moderate complexity.
Serve as point of contact for designated clients/districts and provide customer service support to members.
Interact with various data/information technology systems, including proprietary ARES system and Titan systems.
Research customer issues and refer to internal or external sources as necessary for resolution.
Process enrollment and change forms or data eligibility files including data entry of member information.
Review, correct, and distribute monthly invoices to clients, as required.
Assist is creating renewal packets for clients/districts and producing final annual rate contracts.
Perform audits of eligibility changes made by Operations.
Create reports as assigned.
Process claims and reimbursement requests, as necessary.
Utilize safe work practices and follow directives, policies and procedures for assisting and maintaining a healthy and safe work environment.
Continually look for opportunities and make recommendations to improve process, product, delivery and overall job, department and client experience.
Other duties as assigned.
Specialty Functions:
Client Benefits Administrators may be asked to focus on any number of specializations as required including COBRA, Medicare enrollment, employee eligibility, claims processing, and processing contribution files. Specialty functions can include:
Provide customer service support to COBRA members
Post COBRA payments
Process enrollment and change forms or data eligibility files; Data entry of member information
Determine and verify member eligibility for Trusts
Answer questions regarding eligibility requirements
Process contributions to HRA accounts
Prepare Trust Board Meeting materials
Offer support for online enrollment tool during Open Enrollment
Process Medicare enrollment and change forms or data eligibility files; Data entry of member information
About You
Bachelor’s degree and 1 year related experience required
Ability to work hybrid model out of San Diego, CA - 2x on Site, 3x WFH.
Preferred: Punctuality and adherence to scheduling
Effective verbal, written and communication skills
Ability to research and resolve issues related to benefit(s) eligibility, billing, and coverage issues related to benefits plan(s)
Patience, resiliency and tolerance of stressful situations
Customer-focused and interested in assisting others
Cooperative attitude and ability to work both individually and in a team
Focus and attention to detail
Able to meet tight deadlines and maintain accuracy
Able to learn computer system applications
Able to learn and understand multiple products/benefit levels
Minimum of 4 years’ experience working in Customer Service, health care or related field preferred
Proficiency in Microsoft Word and Outlook
Advanced/Intermediate skill level in Microsoft Excel
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Compensation and benefits
At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.
Competitive compensation
Comprehensive benefits programs designed to support your well-being
Career development opportunities and ongoing learning
A collaborative, people-first culture with accessible leadership
The opportunity to do meaningful work with global reach and local impact
At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.
Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)
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