The Client Associate Assistant (CAA) supports Client Associates by resolving account level and administrative client issues that fall outside the scope of front desk resolution but do not rise to the level of a client escalation.
The CAA also serves as the designated backup for the entire Service Department. When a team member is out or the queue runs heavy, the CAA is expected to step into Receptionist, Eligibility, or Client Associate work and keep the department running. This requires current working knowledge of every function on the team, not only the categories the CAA owns day to day.
The CAA does not own client strategy, renewals, or client escalations.
Primary Ticket Categories
The CAA is the assignee of record for the following HubSpot ticket categories:
- Payment Issues / ACH Setup
- Billing Issues
- Eligibility Issues
- Portal Access / Issues / Primary Contact Updates
- Report Requests
- Form Requests
- Group Reinstatements
- Benefit Summary
- Group Changes
Client and Carrier Support
- Research and resolve billing discrepancies, premium payment failures, and ACH setup or banking change requests, coordinating with carriers and the client’s billing contact
- Investigate group and member level eligibility discrepancies between carrier records, Employee Navigator, and FDN records, and drive them to correction
- Administer client portal access, including new user setup, password and access troubleshooting, and primary contact updates
- Produce report requests, form requests, and benefit summaries accurately and within the requested timeframe
- Process group reinstatements and group level plan changes with carriers
- Liaise with insurance carriers and vendors to resolve open items, following up on pending carrier requests within 2 to 3 business days
- Provide clear, professional communication to clients and brokers in both English and Spanish
Department Backup Coverage
The CAA is cross trained across the full Service Team and provides coverage during absences, PTO, volume peaks, and open enrollment.
- Cover Receptionist duties as needed, including answering incoming phone calls and resolving point of contact requests: ID cards, PCP changes, physician’s search, demographic changes, invoice requests, secure messages, and premium rate requests during open enrollment, directing rate questions to Renewals outside of open enrollment
- Cover ticket assignment when a Receptionist is out, clearing the unassigned queue at clock in, after lunch, and before clock out, with no ticket left unassigned at the end of the day
- When covering assignment, populate all six required fields, paste secure message screenshots into ticket notes before assigning, and send a Teams message to the assigned agent on any Urgent or High Priority ticket
- Cover Eligibility tasks as needed, including terminations, COBRA, additions and new hires, reinstatements, newborn additions, and Employee Navigator imports
- Absorb Client Associate workload as directed, escalating any matter that requires account ownership or client strategy
- Maintain current working knowledge of the SOP standards for every Service Team role so that coverage can begin without ramp up time
Internal Support
- Serve as the first line of support to Client Associates on client issues, taking ownership of assigned work so Associates can focus on escalations and complex matters
- Escalate to a Client Associate when a matter involves a client escalation, EOI post open enrollment, HSA funding, benefit interpretation questions, retro requests, audit discrepancies, or FSA/HSA matters
- Post unfamiliar or uncategorized requests, such as Colonial, Aflac, compliance notices, or stop loss, to the Service Team chat in Teams for guidance before proceeding
HubSpot Ticket Management Standards
The CAA is expected to follow the Service Team SOP without exception. Core requirements:
- Begin each day in Task View. Clear Overdue tasks first, then work Due Today, then review Due This Week. Work from the task list, not the pending queue.
- Forward any client emails requiring a ticket into HubSpot and connect Outlook to HubSpot at the start of each day.
- Use Table View only, with the required column order. Board View is not used by the Service Team.
- Maintain the three required views: Unassigned Tickets, My Open Tickets, and My Pending Tickets.
- Confirm all six required fields are populated on every ticket worked: Contact, Company, Service Type, Assignee, Effective Date where applicable, and Priority.
- Use only approved ticket categories, selecting the most specific category that applies.
- Document every action taken as a Note in HubSpot, in real time and never retroactively.
- Log all calls. Add the contact and dial from the ticket for outbound calls. Use “Log a Call” with notes for inbound calls.
- Add a follow up Task at the moment any ticket is moved to a Pending status. A pending ticket with no active task is a workflow violation.
- Close tickets only when the request is fully completed with no remaining open items.
Service Level and Follow Up Requirements
Condition
Required Response
Urgent priority ticket
Addressed within 1 hour of assignment
High Priority ticket
Completed or escalated same day, by end of business
Pending from Carrier
Follow up within 2 to 3 business days. Document the follow up date and notes. Follow up task mandatory.
Pending from Client
Three follow ups: email at day 2, email at day 4, phone call at day 5. After three unanswered attempts, close using the HubSpot snippet or create a future follow up task.
Pending from FDI
Resolved within 48 hours. Follow up task mandatory.
Performance Expectations
- Timely resolution of assigned tickets within priority SLAs
- Complete and accurate ticket data, with all required fields populated and the correct category applied
- Real time documentation with no undocumented actions on tickets
- Zero pending tickets without an active follow up task
- High level of accuracy and attention to detail on billing, eligibility, and group change work
- Readiness to provide coverage across any Service Team function on short notice, with no drop in service quality or SOP compliance while covering
- Professional, empathetic client and broker communication
- Sound escalation judgment, neither holding matters that belong with a Client Associate nor escalating routine work
- Positive collaboration across Receptionists, Eligibility, and Client Associates
Qualifications
- High School Diploma or equivalent required
- Minimum of two (2) years of customer service experience, preferably within insurance, healthcare, or benefits administration
- Bilingual proficiency in English and Spanish required
- Experience working in a CRM or ticketing system, HubSpot preferred
- Familiarity with employee benefits (medical, dental, vision, FSA/HSA) and carrier billing preferred
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and Google Workspace
- Ability to shift between roles and priorities on short notice while maintaining accuracy