Account Manager-Claims Reporting

Compliance Holdings; South Carolina; Remote; USD 60,000 - 90,000; Full time

Job summary

Lumelight is seeking an Account Manager-Claims Reporting to act as the primary point of contact for clients using our health insurance analytics platform. You will ensure customers receive timely, accurate, and empathetic support for all inquiries related to their accounts while maintaining strict HIPAA compliance.

You will resolve inquiries on stop loss tracking, plan financial tracking and projection, claim reporting, and chronic condition reporting.

Qualifications

• 2+ years using CRM systems for ticket management.
• Strong communication with customers and colleagues.
• Advanced Excel skills for data validation and pivot charts.
• Experience using Outlook for email, scheduling, and rules.
• Ability to lead meetings and inspire confidence.

Responsibilities

• Work with customers to resolve inquiries regarding Lumelight analytics platform.
• Support questions related to stop loss tracking, plan financial tracking and projection, claim reporting, and chronic condition reporting.
• Support customer workflows that require pulling and securely delivering Lumelight data.
• Lead software testing of Lumelight system through specified scenarios during releases.
• Lead projects by facilitating communication for clients adding groups to Lumelight.
• QA newly implemented groups by comparing customer data against Lumelight data post setup.
• Provide SME to the team in analytics or health insurance knowledge.
• Manage multiple questions from various sources while maintaining quick resolutions.

Skills

CRM systems

Communication skills

Time management

Project management

Presentation skills

Relationship building

Tools

SFDC

HubSpot

Zoho

Excel

Outlook

PowerPoint

Job description

Account Manager-Claims Reporting

Who We Are: Lumelight is an integrated workplace administration and compliance business. We serve the brokers and third-party administrators who support employers in the complex, crucial areas of benefits design, compliance and administration. We are hiring for an Account Manager:

The Account Manager-Claims Reporting plays a critical role in delivering exceptional service to clients using our health insurance analytics platform. Acting as the primary point of contact, this role ensures customers receive timely, accurate, and empathetic support for all inquiries related to their accounts. Success in this position requires excellent communication skills, and a strong understanding of healthcare insurance processes, and business analytics. Because this role involves handling Protected Health Information (PHI), strict adherence to HIPAA compliance and data security best-practices are essential.

• Work with customers to resolve inquiries regarding Lumelight analytics platform
• Support customer questions related to stop loss tracking, plan financial tracking and projection, claim reporting, and chronic condition reporting
• Support customer workflows that require pulling and securely delivering Lumelight data
• Lead software testing of Lumelight system through specified scenarios during scheduled and unscheduled releases
• Lead projects - facilitating communication and flow of information for customers who are adding groups to Lumelight
• QA newly implemented groups comparing customer data against Lumelight data post setup
• Provide Subject Matter Expertise to the team in one of the areas of analytics, or health insurance knowledge
• Time management enabling candidates to manage questions from multiple sources while maintaining quick resolution

Qualifications

• ~2+ years’ experience using CRM systems such as SFDC, HubSpot, or Zoho for customer ticket management
• ~ Communicate effectively and efficiently in a manner that builds rapport with both customers and associates
• ~ Advanced or greater level knowledge using Microsoft products including Excel with demonstrated ability to do data validation, pivot charts, and record macros for troubleshooting.
• ~ Experience using Microsoft Outlook to manage incoming messages, schedule meetings, create and maintain rules.
• ~ Ability to lead a meeting, demonstrating and inspiring confidence to customers

A minimum of 3 years of administrative or client management experience. Preferably healthcare, claims processing/adjudication.

• Employee Benefit and Self-Funded Health Plan insurance knowledge a strong plus
• Health care related or prior claims auditing experience a plus.
• Must be able to understand how specific health care benefits are to be administered by reviewing the client’s plan documentation, audit findings and administrator responses.
• Proven excellence in the support and service to complex clients.
• Superior project management, time management and organizational skills and the ability to quickly adapt to multiple priorities.
• Demonstrated relationship building skills and presentation skills including engaging, persuading, and gaining credibility with senior executives within complex organizations.
• Superior problem-solving ability with client-facing experience, preferably customer service experience.
• Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint, etc.) and video conferencing.

This position is a remote position within approved Lumelight states. This job operates in a professional office environment, whether in person or remotely. This role routinely uses standard office equipment such as computers, phones, and printers. Equipment will be provided to you. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Monday through Friday, 40 hours a week, following an agreed-upon schedule.

We are currently recruiting from the following states: All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.