Note: The job is a remote job and is open to candidates in USA. Independent Health is a healthcare organization seeking an Account Specialist to support employer groups and third-party contacts. The role manages account and membership operations, oversees implementations and enrollment activities, resolves complex eligibility and plan issues, and maintains relationships with employers, members, brokers, and business partners.
Responsibilities
- Manage day-to-day group account and membership operations, including enrollment, eligibility, membership maintenance, and fulfillment activities
- Plan, coordinate, and administer open enrollment, new account implementations, plan changes, and other significant account activities
- Oversee electronic enrollment processes and membership data exchanges with employers and third-party administrators
- Monitor and verify membership materials, system transactions, testing activities, and data accuracy
- Serve as a primary point of contact for employers, members, and business partners, responding to inquiries regarding policies, procedures, and account administration
- Provide education, training, and ongoing support to employers to promote effective account management and positive member outcomes
- Tailor service approaches to meet unique employer needs and attend client meetings to strengthen relationships and ensure service expectations are met
- Research, analyze, and resolve complex account, eligibility, and self-funded plan issues by leveraging plan documents, claims data, enrollment records, vendor information, and internal resources
- Take ownership of issues through resolution, ensuring timely follow-up and effective problem solving
- Identify, investigate, and escalate potential fraud, compliance concerns, or operational discrepancies as appropriate
- Recognize and appropriately route sales opportunities, product placement issues, billing concerns, and receivable matters to the appropriate teams
- Maintain technical, operational, regulatory, and industry knowledge needed to effectively perform responsibilities
Skills
- High school diploma or GED required
- Three (3) years of experience in account or member servicing, healthcare operations, or sales operations required
- Ability to make consistent decisions that effectively balance the administration of policy with rational, logical, customer centric servicing
- Ability to understand and articulate complex systems, process and concepts and influence outcomes through clear and effective communication and collaboration
- Excellent verbal, written and interpersonal communication skills required
- Capacity to understand and manage regulatory requirements and professionally participate in external audits and client meetings
- Ability to work overtime, flexible hours, weekends and holidays are required and a condition of employment
- Local travel required
- Any Independent Health associate who uses a motor vehicle in the course of their duties representing Independent Health must be compliant with State Motor Vehicle laws and must follow the Policy that pertains to Driver's License Requirements as a condition of employment
- Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable
- Immigration or work visa sponsorship will not be provided for this position
- Associates degree preferred
- Self-funded healthcare experience preferred
- Salesforce experience preferred
Benefits
- Associates may be eligible for a scorecard incentive
- Full range of benefits
- Generous paid time off
Company Overview