Account Coordinator, PBA

Capital Rx; Denver (CO); Hybrid; USD 63,200 - 79,000; Full time

Job summary

Capital Rx is seeking an Account Coordinator based in Denver, CO, to support and enhance client satisfaction for Health Plan and TPA clients. This hybrid role involves collaboration with teams to meet client needs and involves significant responsibility in managing benefit requests and quality assurance.

The ideal candidate will possess an undergraduate degree and have 1+ years of experience in the health plan or benefits consulting field. Strong communication skills and the ability to manage multiple projects are essential.

Qualifications

• 1+ years of experience in PBM / health plan or healthcare.
• Exceptional written and verbal communication skills.
• Ability to manage multiple complex projects simultaneously.

Responsibilities

• Support implementation and management of client requests.
• Lead quality assurance and testing for claims.
• Collaborate cross-functionally to enhance client satisfaction.

Skills

Strong client relationship building

Data analysis

Microsoft Office proficiency

Education

Undergraduate bachelor's degree or equivalent experience

Tools

SQL

Job description

About Judi Health

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including:

• Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers,
• Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and
• Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform.

Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health.

Location

Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area)

Position Summary

Capital Rx is looking for a results-driven Account Coordinator to support the PBA account teams, supporting Health Plan, TPA, and copay card clients. In this role, you will partner with account teams to enhance client satisfaction and help with day-to-day tasks. You'll collaborate with internal teams to meet the needs of our clients and their members. If you're passionate about building strong client relationships, navigating healthcare trends, and improving processes, we want to hear from you!

Position Responsibilities

• Support implementation and client management teams with all day-to-day client requirements
• Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations
• Analyze incoming client requests and work with internal and external teams to complete required plan documentation
• Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent
• Lead pre- and post-implementation quality assurance and testing to validate coding accuracy
• Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address
• Handle and resolve sponsor and member issues, escalating as needed
• Research and respond to claims processing and system configuration inquiries
• Coordinate integration of other data inputs into client management processes
• Collaborate cross functionally to support general client operations, as required

Required Qualifications

• Undergraduate bachelor's degree, with record of strong academic performanceor equivalent job experience
• 1+ years of proven experience in PBM / health plan, benefits consulting, healthcare
• Track record of building trusting internal and external relationships
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
• Experience working with structured and unstructured data
• Proficient in Microsoft Office, SQL a bonus
• Ability to balance multiple complex projects simultaneously
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily
• Attention to detail & commitment to delivering high quality work product

Salary Range

New York, NY: $69,200 — $86,500 USD

Denver, CO: $63,200 — $79,000 USD

Charlotte, NC: $57,600 — $72,000 USD

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at https://www.judi.health/legal/privacy-policy.