Position Overview
At Zelis, the Client Relationship Manager plays a vital role in ensuring service excellence to Open Access Pricing clients and their members.
This client facing role interacts with providers and members and is considered a subject matter expert (SME) in supporting clients, their employer groups, and health plan members with inquiries, services, or issues.
Key Responsibilities
Handle escalated issues, and contacts as assigned, ensuring timely and thorough research and proper resolution
Respond to inbound inquiries from TPA clients, their Client Employer Groups as well as from Plan members and providers
Collaborate and coordinate interdepartmentally to research and solution for client issues, requests, and needs to bring about resolution within a timely manner
Participate in new client implementations, subsequent group implementations, business requirement sessions, and User Acceptance Testing
Participate in client conference calls as needed
Exemplify professionalism, diplomacy, service excellence, and compliance with established polies, procedures, and protocols
Assist with Memorandums of Understanding and Single Case Agreements, and code pricing within the Visium™ system
Respond to and assist Patient Advocates and Patient Advocacy Supervisor with their questions / issues
Assist with client reporting as needed for Patient and Resolution Advocacy
Identify and recommend opportunities for efficiencies, performance improvement, and system enhancements to ensure service excellence.
Comply with HIPAA regulations and ensure confidentiality of calls, documents, and other sensitive information
Properly document activity and calls in the appropriate system
Qualifications
High school diploma or equivalent required, Bachelor’s degree preferred
5+ years within the Health Insurance industry, patient advocacy, customer service, provider relations, or claims administration
Excellent attention to detail, time management and decision-making skills
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