**Please note: This position is with Nova, a division of Independent Health Corporation (a subsidiary of Independent Health).**
Direct employer group and 3 rd party in-house contact for issues including but not limited to; escalated claims questions, escalated eligibility issues, benefit clarification and billing questions. The account service representative will administer or oversee Benefit Assistant and electronic enrollment implementations and on-going administration of these processes. Responsible for internal and external claim audits. Responsible for leading any implementation process new or renewal. The Client Liaison tracks and audits account set up and the production of membership materials. They are responsible for providing employer centric servicing by collaboratively working with all internal departments resulting in employer satisfaction. They work directly with Client Service Manager and employers to plan and then internally administer open enrollment or other significant account activities. They will understand, interpret and communicate policy and procedures appropriately with internal and external contacts. The Client Liaison recognizes and appropriately triages sales/product placement issues or opportunities and billing and receivable issues.
Minimum of two (2) years experience in business to business sales support or account servicing preferred; self-funded health care experience preferred.
Demonstrated ability to make decisions consistently that effectively balances the administration of policy with rational, logical customer centric servicing.
Demonstrated ability to understand and articulate complex systems, process and/or concepts and influence outcomes through clear and effective communication and collaboration.
Excellent verbal, written and interpersonal communication skills required.
Proficient in desk top tools including Word, Excel and PowerPoint. Salesforce.com experience preferred.
Capacity to understand and manage regulatory requirements and professionally participate in external audits and client meetings.
Ability to work over time, flexible hours, weekends and holidays is required and a condition of employment.
Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities.
Other duties as needed. Every associate is given a job description upon hire outlining the qualifications, duties, and pay grade of the position. Independent Health reserves the right to change job descriptions as necessary.
Independent Health is an equal opportunity employer.
Independent Health - 13 months ago