Consultant - Employee Benefits

relationinsurance; Charlotte (NC); On-site; USD 85,000 - 120,000; Full time

Job summary

Relation Insurance seeks a seasoned Client Consultant to manage health insurance accounts, ensuring client satisfaction and revenue growth. You will lead client teams, coordinate enrollment, develop communications, and maintain carrier relationships.

The ideal candidate has at least seven years in account management in the insurance industry, a Life/Accident & Health license, and advanced designations (CEBS, CBP). Strong knowledge of HIPAA, COBRA, and health plan design is essential.

Qualifications

• Seven+ years of account management experience in the insurance industry, focusing on health lines.
• Experience managing client satisfaction and revenue for benefit programs.
• Strong knowledge of health plan design, benefits administration, and vendor negotiations.

Responsibilities

• Leads client teams' projects, deadlines and meetings utilizing project management tools.
• Establishes carrier/vendor relationships to support enrollment, billing and plan changes.
• Reviews HIPAA/COBRA regulations and ensures compliant service delivery.
• Develops client communications, benefit summaries, and open enrollment materials.
• Creates executive summaries and client-ready reports from vendor data.

Skills

Account management

Insurance knowledge

HIPAA/COBRA knowledge

Client relationship management

Education

Bachelor's degree

Tools

Excel

PowerPoint

Job description

WHO WE ARE

Relation Insurance is a leading, innovative company with a strong commitment to excellence and a passion for delivering cutting-edge solutions to our clients. As a key player in the insurance market, we pride ourselves on our dynamic culture, collaborative environment, and continuous drive for success. With a rich history and a bright future ahead, we are looking for exceptional individuals to join our team and contribute to our ongoing growth and success.

WHAT WE'RE LOOKING FOR

The Consultant serves as the primary business contact for the client and is responsible for client satisfaction. The person in this position is expected to consistently provide excellent customer service to accounts, as well as represent client needs and goals within the organization to ensure legendary service delivery. In addition, the Consultant will build relationships with clients to encourage new and repeat business opportunities. The Consultant is accountable for revenue/profitability for client accounts.

A GLIMPSE INTO YOUR DAY

• Leads client teams' projects, deadlines and meetings utilizing project management tools.
• Ensures compliance with professional standards including use of templates, client calendar and peer review process.
• Develops employee communications strategy and oversees other team members in the execution of this strategy including management of open enrollment process.
• Responsible for establishing necessary carrier/vendor relationships with appropriate contacts to serve clients in handling all administration of eligibility, claims, billing, plan implementation, contracts, plan changes and necessary amendments.
• Works directly with the client and manages the request for proposal (RFP) process with the health insurance carriers and internal underwriter and account managers.
• Reviews the underwriter and/or account manager's compilation of the health benefits information from a variety of sources responses from the carriers and provided data, reviews the transparency documents and maintains all appropriate documents in proper files.
• Peer reviews RFP information, analyzes and interprets the results, edits and finalizes the executive summary report to be sent to the client.
• Reviews claim and utilization data from insurance carriers on a consistent basis, analyzes and interprets data for trends, peer reviews customized reports, and submits reports to client, responding to questions as appropriate.
• Creates client presentations using Excel and PowerPoint to summarize client data obtained from vendors or Relation consultants.
• Develops benchmarking reports by gathering health benefits data to compare a client's plan information) to other companies by industry or geography and provides the information to the client.
• Gathers necessary data from the vendor or client; reviews to ensure it is complete, accurate, and reasonable.
• Values medical, dental and prescription drug plan designs by entering plan design information to develop the relative cost differences between plan designs, in order to compare the client's current plan to alternative designs.
• Develops employee contributions scenarios by entering current employee medical contribution data into an Excel spreadsheet and projecting contributions to the next plan year, taking into account the cost-sharing goals of the client.
• Reviews external vendor contracts, summary plan documents and employee communications to ensure alignment with client expectations and legal requirements.
• Reviews Summary Plan Descriptions (SPD) from the carrier and compares it to the client's benefits for accuracy.
• Understands and demonstrates project management and consulting skills.
• Develops employee communication materials such as benefit brochures, open enrollment presentations, employee memos, etc.
• Recommends process improvements as needed.
• Fully adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
• Performs other projects, duties, and tasks, as assigned.

WHAT SUCCESS LOOKS LIKE IN THIS ROLE

• A Life Accident & Health License from state of domicile is required and must be maintained.
• Advanced professional designation highly desirable (e.g. CEBS, CBP, etc.).
• High School Diploma or equivalent required. Four-year degree preferred.
• Minimum 7 years' account management experience in the insurance industry with a focus on Accident and Health lines of coverage is required.
• Exceptional understanding of the lines of coverage for employee benefit plans: medical, dental, life, long-term disability (LTD), short-term disability (STD), accidental death and dismemberment (AD&D), vision, etc.
• Exceptional knowledge of the rules and regulations associated with HIPAA, COBRA, Health Care Reform and all other legislation and compliance related areas to Group Health programs.
• Exceptional knowledge of insurance markets, products, services, insurance ratings and underwriting procedures.
• (California-Only) In-depth underst