Client Benefit Analyst

United Concordia Dental; United States; On-site; USD 58,000 - 90,000; Full time

Job summary

United Concordia Dental is seeking a Client Benefit Analyst to provide and coordinate account support for experience-rated and community-rated dental groups. You will assist sales and service teams, group administrators, brokers, and plan personnel to resolve benefit interpretations, inquiries, claims adjudication, and billing issues.

The role involves collecting data from multiple sources, analyzing utilization and networks, and making cost-impact recommendations.

Qualifications

• 3 - 5 years of Sales Support
• 1 - 3 years in Insurance
• Producer's License - Accident & Health, or within 45 days of hire.
• 3 years of progressive related experience in lieu of Associate Degree
• Bachelor's Degree preferred

Responsibilities

• Provide account support activities associated with the administration of all experience rated and community rated dental groups.
• Collect and analyze customer specific information including gathering data from multiple sources related to Benefit/Claim Utilization, Enrollment, Networks and making recommendations based on the results of their data analysis.
• Representing UCD at Client meetings, including Open Enrollment meetings and Health and Wellness fairs.
• Other duties as assigned.

Skills

Analytical Skills

Communication Skills

Education

Associate's Degree in Business Administration/Management

Bachelor's Degree in Business Administration/Management

Job description

Company

United Concordia Dental

Job Description

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

• Associate's Degree in Business Administration/Management

Substitutions

• 3 years of progressive related experience in lieu of Associate Degree

Preferred

• Bachelor's Degree in Business Administration/Management

EXPERIENCE

Required

• 3 - 5 years of Sales Support
• 1 - 3 years in Insurance

Preferred

• 1 - 3 years of Dental Sales experience

LICENSES OR CERTIFICATIONS

Required

• Producer's License - Accident & Health, or within 45 days of hire.

Preferred

• None

SKILLS

• Analytical Skills
• Communication Skills

Language (Other Than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type: Office-based
Teaches / trains others regularly: Occasionally
Travel regularly from the office to various work sites or from site-to-site: Rarely
Works primarily out-of-the office selling products/services (sales employees): Never
Physical work site required: Yes
Lifting up to 10 pounds: Constantly
Lifting 10 to 25 pounds: Occasionally
Lifting 25 to 50 pounds: Rarely

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.

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. 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

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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.