Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Websites
Timeline
Generic

Benjamin Hirth

Chicago

Summary

Detail-oriented professional with extensive experience in health insurance member services, specializing in patient communication and benefits coordination. Proven ability to handle HIPAA-compliant data effectively while enhancing operational efficiency. Strong administrative and organizational skills aimed at supporting patient care initiatives. Ready to leverage expertise in a healthcare administration role. Experienced Member Service Representative with a strong focus on health insurance navigation, HIPAA compliance, and conflict resolution. Proven track record in supporting members through complex Medicare plans, ensuring clarity and satisfaction.

Overview

6
6
years of professional experience
1
1
Certification

Work History

Member Service Representative II

GoHealth
Chicago
01.2021 - Current
  • Delivered one-on-one support to GoHealth members for health insurance inquiries and plan selection.
  • Guided members in understanding coverage specifics, available medications, and potential costs.
  • Assisted members with navigating health insurance plans to optimize personal choices.
  • Support GoHealth members in understanding intricacies of Medicare plans, encompassing Medicare Advantage, Medigap, and Part D Prescription plans.
  • Act as a comprehensive resource guide and glossary, aiding members on how to access their providers and prescriptions.
  • Documented all member interactions in online system to ensure compliance with HIPAA regulations.
  • De-escalated member concerns and resolved complex issues through collaboration with claims, underwriting, and provider services.
  • Maintained continuity of care by accurately recording member interactions in designated system.
  • Engaged with internal departments to address and resolve escalated member issues effectively
  • Educated members on plan usage, preventive care benefits, and digital management tools.
  • Achieved or surpassed key performance metrics for call resolution and member satisfaction.
  • Sold and cross-sold products and services tailored to member needs.
  • Collaborated across multiple applications and monitors to enhance operational efficiency.

Senior Benefits Consultant

GoHealth
Chicago
07.2019 - 03.2025
  • Analyzed employee benefits data to recommend effective plans and solutions.
  • Collaborated with clients to assess benefit needs and develop tailored strategies.
  • Managed open enrollment processes, ensuring strict adherence to regulations.
  • Reviewed and interpreted benefit plan documents for accuracy and clarity.
  • Supported HR teams in resolving complex benefits-related inquiries and issues.
  • Conducted market research to remain informed on industry trends and best practices.
  • Ensured compliance with laws governing employee benefits plans.

Direct Medicare Sales Agent

Humana
Chicago
06.2020 - 11.2020
  • Educated clients on Medicare plans and options offered by Humana.
  • Assisted clients in completing enrollment forms and clarifying benefits.
  • Coordinated outreach events to promote Human's Medicare offerings within the community.
  • Collaborated with cross-functional teams to improve customer service experiences.
  • Managed follow-up communications with prospective and existing clients for ongoing support.
  • Reviewed client information for accuracy and regulatory compliance.
  • Generated detailed reports on customer feedback for management analysis.
  • Provided comprehensive product information and addressed inquiries regarding Medicare services.

Education

Associate of Arts - Business Administration

Harold Washington College
Chicago, IL
06-2027

Associate of Science - Fashion Marketing

Illinois Institute of Art - Chicago
Chicago, IL
04-2018

Skills

Health insurance expertise (HMO, PPO, Medicare, Medicaid)

Call center operations

Conflict resolution and de-escalation

Solution-oriented mindset

HIPAA compliance

Claims and benefits explanation

Management software proficiency

Data entry and documentation accuracy

Verbal and written communication

Problem solving and critical thinking

Time management and multitasking

Team collaboration

Interpersonal skills

Empathy and active listening

Adaptability

Computer proficiency (MS Office and more)

Accomplishments

  • Member of test team for new projects and programs
  • Assist new employers on keys to success in their roll
  • Sales trainer

Certification

  • Health & Life Insurance License – State of Illinois

Timeline

Member Service Representative II

GoHealth
01.2021 - Current

Direct Medicare Sales Agent

Humana
06.2020 - 11.2020

Senior Benefits Consultant

GoHealth
07.2019 - 03.2025

Associate of Arts - Business Administration

Harold Washington College

Associate of Science - Fashion Marketing

Illinois Institute of Art - Chicago

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Benjamin Hirth