We are seeking an experienced Member Benefits Specialist to join a well-established organization in the Lexington, KY area. This role is ideal for someone who enjoys helping people navigate their health and employee benefits and has previous experience working directly for a health insurance company. The position will work closely with members, employer groups, and insurance professionals to assist with enrollment, eligibility, claims, benefit questions, and ongoing account support.

Key ResponsibilitiesProcess employee benefit and health insurance applications, review submissions for completeness, and forward completed materials to the appropriate insurance carrier or third-party administrator.

Assist employer groups with enrollment systems, including account access, password assistance, and questions regarding monthly invoices.

Provide responsive customer service to members, insurance agents, internal staff, and other contacts regarding benefit and insurance-related questions.

Help members obtain identification cards and assist with provider, pharmacy, and other benefit-related inquiries.

Educate members on available virtual care, employee assistance programs, and benefits enrollment resources.

Assist members with filing and tracking claims, researching claim issues, and identifying missing information needed for processing.

Communicate benefit-related changes to employer groups, including life insurance age reductions, dependent eligibility changes, and other applicable updates.

Maintain and update group information, including contacts, salary information, beneficiary details, and other account records.

Explain employee benefit programs and requirements, including health savings accounts (HSAs), health reimbursement arrangements (HRAs), flexible spending accounts (FSAs), Section 125 plans, HIPAA, COBRA, qualifying events, waiting periods, and basic Affordable Care Act requirements.

Prepare materials for benefit presentations, open enrollment meetings, and employee communications.

Maintain accurate account documentation within the applicable software system, including correspondence, activity records, and phone notes.

Track prospective business opportunities, gather information needed for quotes, and assist with presenting available health and benefit plan options.

Support marketing and sales representatives with servicing agents, employer groups, and employees within an assigned territory.

Assist insurance agents with the quoting process and help identify opportunities to introduce additional lines of coverage.

Travel within the state as needed for employee benefit presentations, enrollment meetings, and conferences.

Follow up with clients regarding monthly premium payments and delinquent accounts.

Provide backup support for other department team members during absences or periods of increased workload.

Assist with departmental initiatives and special projects, including spreadsheets, audit support, analytical assignments, and cross-functional collaboration.