Senior Benefits Call Center Specialist

Position Summary
The Senior Benefits Call Center Specialist serves as an advanced resource within the Benefits Services Center, responsible for resolving complex and escalated benefits inquiries that require deep subject matter expertise, critical thinking, and cross-functional coordination. This role supports Tier 1 staff, handles sensitive and high-impact cases, and ensures accurate and compliant resolution of issues while delivering an exceptional customer experience. This position works onsite five days per week and collaborates closely with team members and business partners to support service delivery.

Key Responsibilities
• Serve as the primary escalation point for complex, sensitive, or unresolved benefits issues from Tier 1 representatives
• Investigate and resolve advanced cases involving eligibility discrepancies, claims escalations, billing errors, COBRA administration, and vendor-related issues
• Act as a subject matter expert (SME) for all benefits programs, including medical, dental, vision, retirement, voluntary benefits, and leave-related benefits
• Interpret plan documents, summary plan descriptions (SPDs), and policies to ensure accurate guidance and compliance
• Partner with internal teams (HR, Payroll, Finance) and external vendors/carriers to research and resolve issues efficiently
• Manage and track escalated cases through resolution, ensuring timely follow-up and clear communication with impacted employees
• Identify root causes of recurring issues and recommend process improvements or system enhancements
• Support quality assurance efforts by reviewing Tier 1 interactions and providing feedback and coaching
• Assist in developing training materials, job aids, and knowledge base content to enhance team performance
• Handle high-touch employee situations requiring discretion, professionalism, and empathy, including sensitive or confidential matters
• Ensure strict adherence to HIPAA, ACA, COBRA, and other regulatory requirements
Advanced Duties & Escalation Management
• Analyze and resolve multi-layered issues that may involve multiple systems, vendors, or policy interpretations
• De-escalate challenging interactions with professionalism while maintaining organizational standards and protecting employee trust
• Serve as liaison between employees and insurance carriers to resolve claims disputes and appeals
• Audit and validate benefit enrollments, deductions, and eligibility data to correct discrepancies
• Provide guidance on non-routine life event changes and exceptions requiring policy interpretation
• Support implementation of plan changes, system upgrades, and annual open enrollment by addressing escalated concerns and anomalies

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Education & Experience:
• High school diploma required; bachelor’s degree preferred
• 4–6+ years of experience in benefits administration, HR, healthcare, or insurance
• Minimum 2 years in a call center or high-volume service environment
• Demonstrated experience handling escalated or complex customer service issues

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.