Counselor- COBRA

About Aptia

Aptia is a trusted provider of employee benefits and pension administration services, with offices in the U.S. and U.K. supported by shared services in India and Portugal. We manage programs covering over six million people and serving more than 1,100 clients, catering to both B2B purchasers of the administration platform and B2C employees. With our extensive experience in the industry, we deliver efficient and reliable solutions that ensure smooth management of employee benefits programs.

Our dedicated team of experts combines in-depth knowledge with leading technology to simplify the administration process for clients.

The Benefits Counselor is the front line of Aptia Group’s participant experience for COBRA continuation coverage. You will counsel former employees and qualified beneficiaries on COBRA rights and timelines, resolve coverage and billing questions, process elections and payments, and ensure all interactions meet regulatory, client, and quality standards. This posting includes multiple openings under the Benefits Counselor role; by applying you will be considered for all openings associated with this title.

• Participant Counseling & Customer Support
  • Provide clear, empathetic guidance on COBRA eligibility, election periods, coverage options, premium payments, grace periods, and termination rules.
  • Respond to inbound calls, chats, and case tickets; conduct outbound follow‑ups as needed to resolve open cases.
  • Explain complex topics (e.g., subsidy eligibility, coordination with marketplace plans, reinstatements) in accessible terms.
• Case Handling & Processing
  • Initiate, update, and close participant cases; documenting all contacts accurately and timely.
  • Process elections, premium postings, late payments, refunds, and reinstatements in accordance with defined operating procedures.
• Compliance & Quality
  • Adhere to federal COBRA, HIPAA privacy/security, and ERISA requirements; follow state‑specific continuation rules where applicable.
  • Meet quality assurance targets across accuracy, completeness, and compliance checkpoints.
• Carrier & Client Coordination
  • Collaborate with carriers and internal operations to confirm coverage status, effective dates, enrollments, and terminations.
  • Partner with client service teams to support employer‑specific plan / rate nuances, and escalated participant issues.
• Continuous Improvement
  • Participate in training, huddles, and calibration sessions; contribute to knowledge base content.

• Experience: 1‑3 years in benefits administration, health insurance customer service, or TPA operations; COBRA experience required.
• Knowledge: Working familiarity with COBRA regulations, HIPAA privacy/security standards, and ERISA basics.
• Skills:
  • Exceptional verbal/written communication and active listening.
  • High attention to detail; strong documentation discipline.
  • Problem solving and de‑escalation under time pressure.
  • Comfort navigating multiple systems and screens.
  • Must be able to multi‑task (working on administrative tasks in between phone calls).
  • Familiarity with Microsoft suite applications (Word, Excel, PowerPoint).
• Education: High school diploma or equivalent required; associate or bachelor’s degree a plus.

• Prior experience at a third‑party administrator or benefits outsourcing firm.
• Exposure to medical/dental/vision plan structures, premium rate tables, and carrier enrollment workflows.
• Bilingual (e.g., Spanish/English) a plus.
• COBRA certification or industry training (e.g., IFEBP) is beneficial but not required.

• Work Model: Hybrid, in our Lake Mary office a minimum of 3 days per week. A quiet, confidential workspace required at home for participant calls.

• Operating
  
  Hours:
  
  Monday‑Friday, 7:00 a.m. – 9:00 p.m. EST time.
• Multiple shifts within Operating hours
  • Saturday coverage (limited, voluntary or scheduled during peak demand)
• Peak Season Flexibility: Extended hours during Q4/Q1 open enrollment.