Voluntary Benefits Wellness Claims Specialist

What You'll Do:
• Review and process wellness claims (routine preventive care benefits) submitted via phone, portal, or mail.
• Verify enrollment, policy provisions, and annual benefit allowances to determine eligibility.
• Document claim decisions accurately and apply appropriate claim benefits per established procedures.
• Handle basic escalations; resolve customer or client concerns promptly and route complex cases to a VB Claim Manager or Team Leader as appropriate.
• Communicate claim outcomes clearly and professionally to customers and business partners.
• Meet productivity and quality standards by achieving daily/weekly adjudication targets.
• Collaborate with peers and VB Claim Managers to identify trends, share best practices, and resolve recurring issues.
• Support special projects, process improvements, and system enhancements as needed.
• Participate in ongoing training and development to build VB claims knowledge and prepare for progression to higher-level roles.
What You'll Bring:
• High School diploma or GED required; college coursework or degree preferred.
• 1+ years of insurance, healthcare, or customer service experience required.
• Experience in benefits administration or claims preferred.
• Strong attention to detail with the ability to accurately process high volumes of claims.
• Proficiency with Microsoft Office applications (Word, Outlook, Excel).
• Strong verbal and written communication skills with the ability to explain claim outcomes clearly.
• Ability to manage multiple tasks and maintain accuracy in a fast-paced environment.
• Customer-focused mindset with a strong sense of accountability.
• Ability to learn and apply insurance product knowledge, including accident, hospital indemnity, and critical illness wellness benefits.
Pay Transparency
Salary range: $40,000-$52,000
Overtime eligible: Nonexempt
Discretionary bonus eligible: Yes
Sales bonus eligible: No
Actual base salary will be determined based on several factors but not limited to individual's experience, skills, qualifications, and job location. Additionally, employees are eligible for an annual discretionary bonus. In addition to base salary, employees may also be eligible to participate in an incentive program.
Actual base salary within that range will be determined by several components including but not limited to the individual's experience, skills, qualifications, and job location.In addition to base salary, employees may also be eligible to participate in an incentive program.

Skills Required
High School diploma or GED
College coursework or degree
1+ years of insurance, healthcare, or customer service experience
Experience in benefits administration or claims
Strong attention to detail and ability to accurately process high volumes of claims
Proficiency with Microsoft Office applications (Word, Outlook, Excel)
Strong verbal and written communication skills
Ability to manage multiple tasks and maintain accuracy in a fast-paced environment
Customer-focused mindset with strong sense of accountability
Ability to learn and apply insurance product knowledge including accident, hospital indemnity, and critical illness wellness benefits