Account Representative I

Medica Services Company LLC; Omaha (NE); On-site; USD 57,000 - 97,000; Full time

Job summary

Medica is a nonprofit health plan serving diverse communities, seeking an Account Representative I in Omaha, NE. The role focuses on supporting the broker distribution channel for small group Commercial business, guiding enrollment, billing, claims and benefits, and ensuring regulatory compliance.

The successful candidate will manage assigned accounts, build client relationships, and coordinate with internal teams to resolve issues, while working on-site in Omaha three days a week.

Qualifications

• Bachelor's degree or equivalent combination of education and experience required.
• Relevant experience could include Customer Service, Vendor Management, Account Management, Group Health, Benefits Administration, Human Resources, etc.
• Demonstrated proficiency in working with both fully insured and self-funded health plans preferred.
• Experience working with brokers preferred.

Responsibilities

• Manage an assigned portfolio of small group accounts.
• Prioritize workload, monitor account activity, and maintain accurate account documentation.
• Build and maintain strong relationships to support retention and client satisfaction.
• Research, coordinate, and resolve escalated service issues.
• Manage inquiries related to eligibility, billing, enrollment, claims, and benefits.

Skills

Customer Service

Vendor Management

Account Management

Group Health

Benefits Administration

Human Resources

Education

Bachelor's degree or equivalent combination of education and experience

Job description

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Account Representative I

Locations

Showing 1 location

Omaha
Omaha, NE 68164, USA

• Full-Time

Description

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Work with external broker distribution channel supporting new and renewing small group Commercial business, providing guidance on regulatory requirements, processes, products and value adds available. Provide service on enrollment, billing and claims issues. Performs other duties as assigned.

The Account Representative is a small group business specialist with expertise in Medica’s products, pricing, sales guidelines, and operational processes. The incumbent partners with the Agency Relationship Managers to provide consultation and education to Medica’s broker distribution channel on all aspects of Medica’s small group business. The incumbent has on-going interaction with the broker channel to quote, install, retain and service our small group fully and self-insured business.

The Account Representative has significant interaction, collaboration and negotiation with functional content specialists across all operations to address client questions and demands. This position is critical for client satisfaction and the ability to retain the business relationship with Medica.

Key Accountabilities

• Manage an assigned portfolio of small group accounts.
• Prioritize workload, monitor account activity, and maintain accurate account documentation.
• Build and maintain strong relationships to support retention and client satisfaction.
• Research, coordinate, and resolve escalated service issues.
• Manage inquiries related to eligibility, billing, enrollment, claims, and benefits.

Qualifications:

• Bachelor's degree or equivalent combination of education and experience required
• Relevant experience could include, Customer Service, Vendor Management, Account Management, Group Health, Benefits Administration, Human Resources, etc.
• Demonstrated proficiency in working with both fully insured and self-funded health plans preferred
• Experience working with brokers preferred

Specific types of experience or skills required:

• Ability to gain thorough knowledge of federal/state regulations and Medica’s requirements related to small group validation as well as the requirements for submission
• Strong interpersonal, relational skills in the management of client service
• Excellent written and verbal communication skills
• Ability to negotiate successful outcomes with client
• Ability to work independently
• Self-driven, motivated and results oriented

This position is an Office role, which requires an employee to work onsite at our Omaha, NE office, on average, 3 days per week.

The full salary grade for this position is $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US:Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.