Client Benefit Analyst

Highmark Health; Philadelphia (Philadelphia County); On-site; USD 58,000 - 90,000; Full time

Job summary

United Concordia Dental seeks a Client Benefit Analyst to provide account support for experience-rated and community-rated dental groups. You will coordinate prompt assistance to Sales, Service personnel, group administrators, brokers, and Agent Plan staff to resolve benefit interpretations, customer service inquiries, claims adjudication, and billing activity.

You will help with enrollment, network utilization analysis, and cost impact recommendations, representing UCD at client meetings and

Qualifications

• Associate degree required; Business Administration/Management background preferred.
• 3–5 years of sales support experience in insurance.
• Licenses: Producer’s License - Accident & Health or within 45 days of hire.

Responsibilities

• Provide account support activities for experience-rated and community-rated dental groups.
• Coordinate prompt support to Sales and Service personnel, group administrators, brokers, and Agent Plan staff.
• Analyze data from multiple sources for Benefit/Claim Utilization, Enrollment, Networks, and cost impact.
• Represent the company at client meetings, Open Enrollment sessions, and wellness events.
• Support renewal and new business efforts during renewal and enrollment periods.

Skills

Analytical Skills

Communication Skills

Travel 0-25%

Education

Associate’s Degree in Business Admin/Management

Bachelor’s Degree in Business Admin/Management

Job description

Company :

United Concordia Dental

Job Description :

JOB SUMMARY

This job provides account support activities associated with the administration of all experience rated and community rated dental groups. The incumbent is responsible for providing or coordinating prompt support to UCCI Sales and Service personnel, group administrators, brokers, and Agent Plan personnel to ensure the resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. This job is ultimately responsible for ongoing account retention, satisfaction, and administration, complementing the efforts of Sales and Service Executives. This activity is intensified and focused for new accounts. This additionally includes identifying and resolving problems related to benefit interpretations, rating concerns and any subsequent adjudication requirements. To this end, the incumbent cultivates and maintains efficient working relationships with key internal areas, such as Customer Service Operations (Claims, Dental Benefits, Customer Service, Membership & Billing), Provider Data Management, Underwriting, and Professional Relations.

ESSENTIAL RESPONSIBILITIES

Provide account support activities associated with the administration of all experience rated and community rated dental groups. The Client Benefit Analyst is responsible for providing or coordinating prompt support to UCCI Sales and Service Personnel, group administrators, brokers, and Agent Plan personnel to ensure the resolution of issues related to benefit interpretations, customer service inquiries, claims adjudication, benefits issues, membership and billing activity, etc. Collect and analyze customer specific information including gathering data from multiple sources related to Benefit/Claim Utilization, Enrollment, Networks (utilization, disruption, geo-access) and making recommendations based on the results of their data analysis. This includes benefits design analysis based on benefit utilization while factoring in financial analysis to determine cost impact. Representing UCD at Client meetings, including but not limited to, Open Enrollment meetings and Health and Wellness fairs. The Client Benefit Analyst is expected to sell at member level for both renewal and new business clients at open enrollment in addition to acting as an oral health wellness consultant at renewal and new business client wellness events. Other duties as assigned.

EDUCATION

Required Associate's Degree in Business Administration/Management

Substitutions

3 years of progressive related experience in lieu of Associate DegreePreferredBachelor's Degree in Business Administration/Management

EXPERIENCE

Required3 - 5 years of Sales Support1 - 3 years in InsurancePreferred1 - 3 years of Dental Sales experience

LICENSES OR CERTIFICATIONS

RequiredProducer's License - Accident & Health, or within 45 days of hire.PreferredNone

SKILLS

Analytical SkillsCommunication SkillsLanguage (Other than English):NoneTravel Requirement:0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsRarely

Disclaimer:

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement

: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:$58,100.00

Pay Range Maximum:$90,000.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. California Consumer Privacy Act Employees, Contractors, and Applicants Notice