Account Specialist

Independent Health; Buffalo (NY); On-site; USD 33,000 - 37,000; Full time

Job summary

Independent Health, headquartered in Buffalo, NY, seeks an Account Specialist to serve as the employer group and third-party contact for claims, eligibility, benefit clarification and billing. You will manage a select group of accounts, maintain relationships with decision makers and brokers, and oversee new and renewing account implementations.

You will collaborate with internal departments to ensure employer satisfaction, interpret policy details, and identify sales opportunities and billing

Qualifications

• High school diploma or GED required.
• Associates degree preferred.
• Three (3) years of experience in account or member servicing, healthcare operations, or sales operations required.
• Self-funded healthcare experience preferred.
• Ability to understand and articulate complex systems, processes and concepts with clear communication.
• Excellent verbal, written and interpersonal communication skills.
• Salesforce experience preferred.
• Ability to work overtime, flexible hours, weekends and holidays; local travel.
• Compliance with state vehicle laws when using a vehicle for work.

Responsibilities

• Manage day-to-day group account and membership operations, including enrollment, eligibility, membership maintenance, and fulfillment.
• 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.
• Respond to inquiries regarding policies, procedures, and account administration.
• Provide education and ongoing support to employers to promote effective account management.
• Attend client meetings to strengthen relationships and ensure service expectations are met.
• Identify, investigate, and resolve complex account and self-funded plan issues using plan documents and data.

Skills

Customer service

Interpersonal communication

Salesforce experience

Problem solving

Education

High school diploma / GED

Associates degree preferred

Tools

Salesforce

Job description

FIND YOUR FUTURE

We\'re excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview

The Account Specialist will serve as the employer group and third-party contact for issues including but not limited to claims, eligibility, benefit clarification and billing. They will serve as the primary account representative for a select group of accounts, maintaining existing relationships with key decision makers and brokers to facilitate member retention and growth. The Account Specialist will oversee the implementation process for assigned new and renewing accounts. They will provide employer centric service by collaboratively working with all internal departments resulting in employer satisfaction. This role will work directly with Account Managers and employers to plan and internally administer account activities. They will need to understand, interpret and communicate policy and procedures appropriately with internal and external contacts and recognize and appropriately triage sales/product placement issues or opportunities and billing and receivable issues.

Qualifications

High school diploma or GED required. Associates degree preferred. Three (3) years of experience in account or member servicing, healthcare operations, or sales operations required. Self-funded healthcare experience preferred. 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. Salesforce experience preferred. 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.

Essential Accountabilities

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 escape 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.

Hiring Compensation Range

Hiring Compensation Range: $24.00 - $27.00 hourly. Compensation may vary based on factors including but not limited to skills, education, location and experience. In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

Equal Opportunity / Affimative Action Employer

As an Equal Opportunity / Affimative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant\'s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.

Company Culture

The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation. Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you\'re part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more.

We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans.