<p>ESSENTIAL DUTIES AND RESPONSIBILITIES</p> <ul> <li>Maintain consistent contact with all client Group Administrators to ensure that there aren't any problems as well as convey a positive customer service message to the account. This can be done by phone for small groups and via quarterly site visits with large accounts. </li><li>Handle all employer level billing problems on behalf of the Group Administrator with their respective carriers. Document all billing service issues in BenefitPoint. </li><li>Handle all employee level claims issues on behalf of the employee with the respective carrier. Document all claims service issues in BenefitPoint. </li><li>In order to remain in compliance with HIPAA regulations, maintain confidentiality on behalf of the employee while handling claims issues. Information relative to a specific employee's claims should NOT be communicated to the Group Administrator or anyone at the employer level without the employee's consent. </li><li>Maintain current information relative to carrier's respective networks as well as claim eligibility requirements relative to In Network/Out of Network specifics to administer claims issues. </li><li>Present on quote activity in process staff meetings as needed. </li><li>Prepare and present quarterly, semi-annual and/or annual utilization reports of large group client's benefit plan performance and comparisons, with actionable analysis and recommendations. </li><li>Meet weekly with Producers to update them on status of all accounts in the quoting process (can be done in weekly staff meeting). </li><li>Meet weekly with Producers to update them on any service issues (billings, claims, etc.) that aren't meeting quality or acceptability levels of clients (can be done in weekly staff meetings). </li><li>Where required by Producer, conduct enrollment meetings with employees to collect required carrier information. </li><li>Manage submission of employer applications to carriers as required. </li><li>Manage employee applications to carriers, including confirmation that all information is complete and meets carrier's standards (scrubbing). </li><li>Maintain current knowledge of submission requirements of each individual carrier. </li><li>Upon submission of application package to carriers, conduct follow-up to confirm final rates or missing information as needed to complete the submission. </li><li>Where required by Producer, conduct benefits meetings with clients and employees (new or renewal) to present benefit summaries or changes to benefits. </li><li>Whether renewing or enrolling with a new carrier, the Account Manager is responsible for updating the electronic version of the Group Summary as well as entering the data into BenefitPoint. </li><li>Via reporting function in BenefitPoint, conduct weekly review of open service issues to ensure that all issues are handled in a timely fashion. </li><li>Perform other tasks as assigned by management. </li></ul> <p>EDUCATION AND/OR EXPERIENCE</p> <ul> <li>Associate's degree in a related field. </li><li>5+ years of related experience and/or training. </li><li>Equivalent combination of education and experience. </li></ul>