Employee Benefits Account Manager

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Maintain consistent contact with clients. Convey a positive customer service message.

• Facilitate all employer level service and billing problems with their respective carriers. Document all service and billing issues in ImageRight.

• Facilitate employee level claims issues with the respective carrier and/or provider. To remain in compliance with HIPAA regulations, maintain confidentiality on behalf of the employee while handling claims issues. Document all claims service issues in ImageRight.

• Maintain current information relative to carrier's respective networks as well as claim eligibility requirements relative to In Network/Out of Network specifics to facilitate claims issues.

• Assist with preparing quarterly, semi-annual and/or annual stewardship reports of large group client's benefit plan performance and comparisons, with actionable analysis and recommendations.

• Meet weekly with Producers to update them on status of all accounts in the renewal and/or marketing process and any service issues (billings, claims, etc.).

• Manage submission of employer applications to carriers as required.

• Manage employee applications to carriers at initial case installation, including confirmation that all information is complete and meets carrier's standards.

• Maintain current knowledge of marketing requirements of each carrier and/or vendor.

• Upon submission of application package to carriers, conduct follow-up to confirm final rates or missing information as needed to complete the submission. Once issued audit policy documents and file all in ImageRight.

• Conduct enrollment and/or benefits meetings with clients and employees (new or renewal) to present benefit summaries or changes to benefits virtually or on site.

• Update the electronic version of the Group Summary for new and renewing groups and enter/update client/policy data in BenefitPoint.

• Conduct a weekly review of open service issues using ImageRight tasks to ensure that all issues are handled in a timely fashion.

• Assist with the implementation of new and renewal groups on benefit administration platforms, including but not limited to Employee Navigator and PlanSource. Responsibilities will vary by system and may include collecting plan information, testing and auditing sites upon completion, assisting in maintaining the document library, and monitoring/troubleshooting file feed error reports.

• Perform other tasks as assigned by management.

EDUCATION AND/OR EXPERIENCE

• High School Diploma plus additional coursework in areas such as basic accounting, computer, etc. equivalent to two years of college; and the related experience listed below; or equivalent combination of education and experience.

• 3+ years of insurance agency or company experience specializing in employee benefits and self-funded medical plans.

• Working knowledge of fully insured and self-funded plan underwriting, financing, and/or funding approaches.

• Experience working with Third Party Administrator's (TPA) and Pharmacy Benefit Managers (PBM's) in resolving issues related to billing, eligibility and claims issues.

• Working knowledge of Employer group wellness programs and legislative guidelines.

• Working knowledge of PPACA, HIPAA, COBRA, FSA/HSA/HRA and the ability to keep clients in compliance.

• Working knowledge of ben admin platforms, including Employee Navigator and PlanSource.

• Equivalent combination of education and experience.