Description
At Gusto, we're on a mission to grow the small business economy. We handle the hard stuff , payroll, health insurance, 401(k)s, and HR , so owners can focus on their craft and their customers.
As a Member Fulfillment Specialist, you're the link between our customers and their health insurance carriers , ensuring their benefits are delivered accurately and on time. You'll work across carrier portals, Salesforce, and Gusto's internal systems, and lean into AI tools to work smarter.
If you take pride in getting the details right and helping customers get the coverage they deserve, this role is for you.
Our team, Member Fulfillment, ensures the promise of benefits becomes reality. We sit between health insurance carriers and Gusto's customer-facing teams, shepherding employer and employee benefits across the finish line.
Here's what you'll do day-to-day:
- End-to-End Enrollment: Manage the intake, submission, and confirmation of group health insurance selections for both employees and employers, ensuring all carrier documentation is accurate and complete.
- Carrier Liaison: Master carrier-specific portals and requirements to efficiently process orders and navigate approval workflows.
- Eligibility & Compliance: Review customer data against carrier eligibility standards to proactively mitigate errors and ensure high-quality plan adherence.
- Cross-Functional Collaboration: Partner with teams across the org , including Licensed Benefits Advisors and Benefits Care , to deliver benefits in full and on time, year-round.
- Resolution Management: Act as the primary point of contact for follow-up requests from carriers, resolving information gaps or plan changes with urgency.
- Process Optimization: Identify and escalate opportunities for workflow enhancements, using your expertise to increase team efficiency and accuracy.
- Expert Communication: Provide clear, professional guidance on healthcare enrollment to customers and internal partners via written and verbal channels.
We're looking for someone with 6 months to 2 years of professional work experience, ideally within healthcare, health insurance brokerage, or a fast-paced startup environment. You should be proficient in Google Workspace, Microsoft Office, Adobe, and Salesforce, and have a proven success in metrics-based roles where data accuracy and hitting KPIs are central to customer success.