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ADP Resolution Support Spec I (Health & Benefits) in Florham Park, New Jersey

ADP is hiring a Customer Service Resolution Support Specialist I.

Responds to requests for research and issue resolution that require research time to resolve, thereby allowing front line associates to be available to focus on servicing clients. Issues may vary from basic and administrative to complex, technical or plan document related. Submits adjustments and determines appropriate corrective action to resolve issues and minimize impact to clients and the agency. May contact clients directly depending on work type and job level. Corrects system data as appropriate and recommends solutions for continuous improvement. Documents notes and outcomes in CRM. Meets internal SLAs for response times. Acts as key resource for internal and external clients.. Acts as an SME or represent the business in projects and initiatives.

Receives requests for research and issue resolution via phone, email, and CRM queues from internal (ie: Sales, Payroll, HRBP and Operations) and external (ie: Carriers, CPA/Wholesale and insureds) clients. Determines appropriate corrective action to resolve issues and minimize impact to clients. Corrects system data as appropriate. Documents notes and outcomes in CRM. Meets internal SLAs for response times. Has a clear understanding of relationship management and the importance of developing and maintaining relationships with ADPIA's internal and external partners.

Successfully navigates through all systems and properly utilizes each system to its full potential i.e. AOS, IS Apps, Vision, TOPS, FTS, RUN, Clarify, QBMS, Insureon, Carrier Websites, COGNOS and LUMIN. Exhibits understanding of and utilizes all systems at the point of call. Is able to identify differences in policy types, lines of business and payroll platform. Demonstrates understanding of the process and is able to troubleshoot issues with different stages of the policy cycle and payroll integration including: implementation, renewal, endorsements, audit, enrollment / terminations / life event changes, Pay-by-Pay, Advantage Bundles and Benefit Manager.

Understands procedures for requests that include internal and external partners (ie: Team India and Carriers) and reconciliation issues. Demonstrates understanding of the concept behind adjustments (when necessary and what supporting documentation is needed).

Effectively explains applicable insurance coverage and corrective action or adjustments required to ensure adequate coverage such as (but not limited to):

  • Limits of Liability

  • Waivers of Subrogation

  • Employee Classification

  • Experience Modification

  • Summary of Benefits

  • Waiting Periods

  • Bill reconciliation

  • Deductibles / Coinsurance

Demonstrates an ability to reconcile state specific forms, applicable premium adjustments, and employer invoices. Understands State and Carrier rules and regulations including DOI legislation. Competently explains processes and procedures with regards to audit, remarketing, renewals, endorsements, claims, carrier non-payments and enrollments, terminations and life changes.

Exhibits understanding of product features and demonstrates strong technical expertise in all aspects of our products and services to (i.e. Pay by Pay, Deduction Management, Certificates of Insurance, etc.) adequately service our internal and external clients. Brings substantive conflict and disagreements into the open and attempts to resolve them, escalating them to management when appropriate. Makes procedural or process suggestions for achieving team goals/performing functions. Demonstrates proficiency in the use and application of systems needed to be effective and shares this knowledge with others. Develops and applies knowledge of the business, products, systems and technology, including updating procedures and LUMIN. Demonstrates possession of and uses cross-functional/ departmental knowledge.

PREFERRED QUALIFICATIONS: Preference will be given to candidates who have the following:

  • Bachelor's Degree or its equivalent in education and experience

  • Insurance, Computer Science, Business, or related

  • P & C License, Life, Health & Accident Licenses

  • 1-2 years of experience in Client Service

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