Account Manager

Job Summary :

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The Account Manager is a technical resource to clients and prospects who is responsible for the ongoing management of assigned clients.

This position coordinates internally to facilitate the implementation of new or renewing accounts to ensure the highest level of service is met for the life of the plan.

The Account Manager will proactively identify trends in service issues utilizing benefits administration technology and develop corrective action utilizing knowledge about group benefits plans.

Duties and Responsibilities

Oversee all policy activity aspects of assigned accounts including, but not limited to implementation, member issues, delinquencies, stop-loss policy coverage status, enrollment maintenance and others.

Engage appropriate resources as needed for assistance.

• Manage self-funded employee benefits administration; assisting current and new clients with questions, claims and billing issues to a successful resolution.
• Execute the pre-renewal and renewal process. Assess and determine client needs to determine the best benefit options.
• Organize and present client meetings to include employee enrollment meetings.
• Lead the process for plan enrollment including employee communication, case submission, plan implementation and follow through on all processes.
• Serve as a resource to clients for current market condition and ongoing benefit regulation changes, industry information and underwriting.
• Learn and become an effective user of benefit administration technology in order to best assist clients, create and run reports, interact with operations, optimal record keeping and client management.
• Participate in industry events and other training to maintain knowledge and skill development.
• Actively seek referrals from current client base for new business prospects.
• Develop strong working relationships with the broker and key contacts for assigned accounts.
• Interact with contacts at various vendors that support the accounts benefits administration.
• Approve client plan documents (SBC’s, SPD Summaries, etc.) and employee ID Cards prior to generation.
• Track and review employer claims for appropriateness and payment. Approve high dollar claims for payment.
• May lead and mentor assistant account managers.

Required Knowledge, Skills and Abilities

• Bachelor’s degree in a field such as business administration, accounting, finance, or a related field or equivalent experience.
• Three years of experience and demonstrated proficiency in third-party, self-insured account management to include medical, dental, life and other ancillary products including types of stop loss insurance.
• Possess a clear understanding and ability to explain employee benefits plans, regulations, and administration as well as major legislation that impacts benefits such as Health Care Reform and American Rescue Plan Act.
• Experience with benefit administration platforms such as Javelina preferred.
• Knowledge of medical terminology and Diagnosis Codes (ICD-9 & ICD-10) is helpful.
• Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint.
• Ability to use a computer which includes expert keyboard and navigation skills and learning new programs.
• Communicate clearly and professionally with internal and external customers.
• Work effectively as part of a team to achieve established outcomes.
• Pay close attention to detail in all aspects of the job.
• Make decisions using available resources and sound judgment.
• Maintain confidentiality and discretion.
• Identify and resolve problems in a timely manner, gather and analyze information skillfully.
• Share knowledge with associates by effectively communicating and providing follow-up.
• Open to others' ideas and exhibits a willingness to try new things.
• Demonstrate accuracy and thoroughness; monitor work to ensure quality.
• Prioritize and plan work activities to use time efficiently.
• Adapt to changes in the work environment, manage competing demands and is able to deal with frequent change, delays, or unexpected events.
• Act in such a way to instill trust from management, other associates, as well as customers.

Physical Demands - The physical demands described here are representative of those necessary for an employee to successfully perform the essential functions of this job.

Reasonable accommodation can be made to enable individuals with disabilities to perform the essential functions.

• Constant : Talk, hear, speak, and use hands and fingers to operate a computer, telephone, keyboard / mouse; occasionally move about the office.
• Constant : Specific vision abilities required by this job include close vision requirements due to computer work for full shift.
• Occasional : Lift and / or move up to 10 pounds.
• Constant : Regular, predictable attendance is required.
• Constant : While performing the duties of this job, the employee is regularly sitting for the full shift.

Work Environment - The work environment described is representative of what must be met by an employee successfully perform the essential functions of this job.

The physical environment is indoors in a controlled climate, office setting. The noise level may be low to moderate.

The duties described are representative, but not restrictive of tasks that may be assigned or of the abilities required to do the job.

The description is subject to change at any time. Other related duties may be assigned.

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