Ejecutivo(a) Senior De Cuentas

MCS Health; San Juan (PR); On-site; USD 60,000 - 86,000; Full time

Job summary

MCS Health in Puerto Rico seeks a Senior Account Executive to represent the company in service procedures and group renewals. You will ensure effective attendance, communication, and resolution of client issues, serving as the primary liaison between employers or groups and management.

The role involves coordinating renewals, addressing service issues, visiting clients, delivering materials, explaining benefits, and supporting group implementations.

Qualifications

• Bachelor's Degree in Business Administration, Public Administration, Health Services Administration, or related fields.
• At least three (3) years of experience in customer service, account management, or similar functions in the healthcare insurance industry preferred.
• Licenses: Driver's License (PR), Life and Disability Insurance Agent License, Health Services License; willing to become certified if not licensed.

Responsibilities

• Represents the company in service procedures and group renewals.
• Acts as primary liaison between employers/groups and management.
• Collaborates with Finance on renewals and discusses renewal proposals with clients.
• Resolves service issues and documents visits and requests.
• Coordinates delivery of materials and prepares reports with insights and trends.

Skills

Spanish Advanced

English Advanced

Education

Bachelor's Degree in Business Administration/Health Services Administration

Associate’s Degree

Job description

The Senior Account Executive represents the company in official service procedures and group renewals. Ensures effective attendance, communication, and resolution of various service-related situations as required by the clients. Serves as primary liaison between the employer or group and the management of the company.

ESSENTIAL FUNCTIONS:

• Collaborates with the Finance department for the renewal of assigned groups. Develops initiatives to discuss renewal proposals with the producer or client. Notifies the Closing/Pre-Implementation area of any agreements made.
• Addresses, follows-up, and resolves service issues reported by customers or producers. Additionally, documents visits, agreements, and customer requests while maintaining a log of these situations.
• Conducts visits to customers to address their requests, ensure service quality standards are met, and contributes to the group’s renewal efforts. Prepares and discusses an individual work plan with each assigned group. Additionally, participates in information booths and meetings with producers and employers as needed, which may include activities scheduled after business hours. Organize interventions with clinical initiatives programs, coordination of benefits, and corporate presentations, among other interventions.
• Coordinates and ensures the delivery of cards, directories, and any other necessary materials directly to the client, producer, or identified dedicated units.
• Prepares and presents reports of experience or data analysis according to frequency and performance guarantees, including recommendations and trends in Puerto Rico or the United States, and according to the established schedule.
• Delivers and explains the administrative handbook and/or materials to new hire groups. Provide benefits orientation to employees (Benefits Presentation), as required.
• Participates in group implementation meetings for coverage or group changes and coordinates the training and maintenance of the company systems platforms, supplies, and equipment.
• Responsible for managing the Designation of Representative document, which is the Health Insurance Portability and Accountability Act (HIPAA).
• Requests to the Legal area for the development of contracts to deliver and discuss with the client, get the client's signature and ensure compliance with the different internal departments.
• Validates the benefits in the system with the client for new groups and/or after the renewal of groups with changes and coordinates the issuance and delivery of Certificates of Coverage as provided by the Insurance Code and the group request for proposal (RFP).
• Serves as skilled in monitoring the operation and processes and ensures that commitments completed in the RFP are fulfilled, and, if not met, escalates the situation with the appropriate departmental management for resolution.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Bachelor's Degree in Business Administration, Public Administration, Health Services Administration, or related fields. At least three (3) years of experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.

OR

Education and Experience: Associate’s Degree. At least five (5) years of experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.

Proven experience may be replaced by previously established requirements.

Certifications / Licenses: A Driver's License valid in the Commonwealth of Puerto Rico is required. A valid Life and Disability Insurance Agent License and Health Services License is required. (Unlicensed candidates or those with a provisional license are accepted. If not licensed, candidates must commit to becoming certified by passing the examination provided by the Commissioner of Insurance on their first or second attempt.)

Other: Car in good condition, available to travel to various locations in Puerto Rico.

Languages:

• Spanish – Advanced (comprehensive, writing and verbal)
• English – Advanced (comprehensive, writing and verbal)

We are an Equal Employment Opportunity Employer and take Aff….

MCS Healthcare Holdings, LLC. (MCS)is an Equal Employment Opportunity Employer and take Aff….