Account Manager (3396)

Job DetailsJob Location: Orange, CA 92868Position Type: Full TimeSalary Range: $26.00 - $36.00 Hourly Purpose of Position: To support account management ticketing from our broker partners and our internal W&B staff. Account management ticketing includes, but is not limited to, provider/RX search, claims, processing eligibility, policy changes, research, and online enrollment support. Position may require mandatory overtime during months of heavy volume. Essential Functions: Account Management Ticketing Establish and maintain strong professional relationships with carrier service teams Act as liaison between agency/group and carriers to resolve all service requests, including but not limited to billing inquiries, claims, eligibility, renewal processing, and customer service requests as defined in Standard Operating Procedure (SOP). Ensure that acknowledgment, status updates, and follow-up outreach happen in the turnaround defined in the Standard Operating Procedure (SOP). Detailed notes, emails, tasks, and phone call details should be logged in a Salesforce ticket as defined in the Standard Operating Procedure (SOP) Conduct thorough Provider/Rx searches and network analyses. Proficiently know carrier partner support resources, including carrier portals and service teams available Online Enrollment Ticketing Be proficient in tickets for a demo, loading, quality assurance, and support for tech ticketing Follow defined SOP, including turnaround time, for loading and quality assurance for tech ticketing Assist in projects needed to maintain information on online enrollment vendors, including, but not limited to, rate/document library updates. Establish and maintain partnership relationships with vendor support teams and be familiar with available support resources Use Subject Matter Expert knowledge of benefits technologies and critical thinking skills to accurately respond to internal and external customer inquiries Act as liaison between agency/group and vendor to resolve service requests, including but not limited to training needs, integrations, and escalated needs. Participate in review, testing, and feedback for new tech team vendors and current vendor enhancements Report any ticketing errors or escalations promptly to the Team Lead and Director of Account Management Online Enrollment Eligibility Ticketing Follow SOP to process eligibility, demographic, and open enrollment changes on behalf of the agency within the online enrollment vendor. Onboard new groups to Eligibility service model including reviewing Ease, Employee Navigator, updating Salesforce, and updating internal tracking guides. Assist in preparing agency reports on ticketing and current Eligibility groups as requested Attend meeting with agency partners to review ticketing and feedback as requested Renewal Support Prepare ADPIA renewal report on a monthly basis with delivery to the Director of Account Management Gather renewals from major medical carriers within 60 days of renewal as defined in SOP. Prepare a spreadsheet to include renewal percentage increases as defined in SOP. Monitor [email protected] and support requests for renewals Ticket Scrubbing Preparation and scrubbing of tickets submitted via email or Salesforce as defined in SOP. Salesforce: Keep all ticketing information accurate and up-to-date in Salesforce, including ticket status and email/telephone correspondence tracking Office Administration Ensure company payroll guidelines are followed in reference to timesheets and PTO Assist with special projects as needed. Follow security protocols to ensure all data is secured and HIPAA compliant. Miscellaneous: Develop and maintain collaborative working relationships with internal contacts, including underwriting, sales, compliance, and finance. Collaborate with leadership on development and updates on Standard Operating Procedures (SOPs). Respond to inquiries from clients professionally and within timeframes assigned. Support training needs for new team members as requested by leadership Report any ticketing errors or escalations promptly to the Team Lead, Supervisors, and/or the Director of Account Management On-site or remote regular attendance and punctuality are essential functions of the job. Perform other business tasks or functions as assigned.

Qualifications

Knowledge, Skills & Abilities Required: Must speak fluent English and communicate effectively. 1-2 years of experience with group insurance preferred. Must have strong people skills, strong phone skills, and the ability to prioritize. Must be detail-oriented, able to work independently in a fast-paced environment with constantly changing parameters. Must be proficient in Word and Excel. Proficient in Microsoft Office programs, including Word, Excel, PowerPoint, and Outlook. Adhere to all PHI (Protected Health Information) and HIPAA (Health Insurance Portability and Accountability Act) guidelines. Educational Requirements: High School Diploma or equivalent required. College degree preferred. Industry designations helpful, but not required Health Insurance License preferred, but not required Physical Requirements: Must be able to sit for extended periods of time, and occasional standing and walking. Must have adequate hearing for phone work. Vision requirements include close vision and the ability to adjust focus. Must be able to communicate effectively in English. Must be able to use a keyboard and other office equipment. Ability to lift up to 10 pounds occasionally. Apply To This Job