Account Manager-Claims Reporting

Compliance Holdings; Utah; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Remote work

Job summary

Lumelight, LLC. is seeking an Account Manager-Claims Reporting to serve as the primary contact for clients using the health insurance analytics platform. You will ensure timely, accurate, and empathetic support, with a strong focus on PHI handling and HIPAA compliance.

Responsibilities include resolving inquiries, leading testing during releases, and guiding client groups through Lumelight workflows, while providing SME insights in analytics or health insurance knowledge.

Qualifications

• 2+ years using CRM systems (SFDC, HubSpot, Zoho) for ticket management.
• Strong communication and rapport-building with customers and colleagues.
• Advanced MS Excel skills: data validation, pivot charts, macros.

Responsibilities

• Resolve customer inquiries about the Lumelight analytics platform.
• Assist with stop loss tracking, plan financial tracking, claim reporting, and chronic condition reporting.
• Pull and securely deliver Lumelight data for customer workflows.
• Lead software testing during releases.
• Coordinate projects for clients adding groups to Lumelight.
• QA new groups by comparing client data with Lumelight data post-setup.
• Provide SME in analytics or health insurance knowledge.

Skills

CRM systems

Communication

Data validation

Pivot charts

MS Excel

Meeting leadership

Time management

Customer service

Education

Healthcare/claims knowledge

Tools

Microsoft Office

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 handle the complexities of benefits compliance and administration, empowering you to focus on what you do best.

We are hiring for an Account Manager:

Description

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.

Job Duties and Responsibilities:

• 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

Skills and Desired Qualifications:

• Time management enabling candidates to manage questions from multiple sources while maintaining quick resolution
• 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

Education and Experience:

• 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.
• Strong analytical critical thinking ability along with excellent written and verbal communication skills.
• Strong ethical and professional conduct with a commitment to objectivity and confidentiality.
• Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint, etc.) and video conferencing.

Work Environment:

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.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk and hear. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Expected Hours of Work:

Monday through Friday, 40 hours a week, following an agreed-upon schedule.

We are currently recruiting from the following states: Arizona (AZ), Florida (FL), Georgia (GA), Indiana (IN), Iowa (IA), Kentucky (KY), Louisiana (LA), Maryland (MD), Michigan (MI), Minnesota (MN), Missouri (MO), Montana (MT), Nebraska (NE), Nevada (NV), New Mexico (NM), North Carolina (NC), North Dakota (ND), OHIO (OH), Pennsylvania (PA), South Carolina (SC), South Dakota (SD), Tennessee (TN), Texas (TX), and Utah (UT).

Lumelight, LLC. is an equal opportunity/affirmative action employer. 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.