About this role
Company : HM Insurance GroupJob Description : JOB SUMMARY
This job provides account support activities associated with the implementation and administration of groups and accounts. Provides assistance with non-standard benefit implementation tasks. Identifies and resolves problems related to benefit interpretations, non- standard benefits, handle rating concerns, and coordinate claim extracts and any subsequent adjudication requirements. The incumbent may have direct interaction with producers, clients and sales reps to ensure complete implementation, on-going service and all renewal activity. The incumbent has foundational knowledge and experience, is building higher-level knowledge and skills, and makes independent contributions to projects.
ESSENTIAL RESPONSIBILITIES
• Load and maintain group information and benefit files.
• Interact and provide support activities to Account Managers.
• Resolve benefit inquiries received from Account Managers, producers, sales reps and small market clients. May coordinate meetings, projects, implementations with clients and core partners.
• Handle error management and ensure files are corrected.
• Analyze/coordinate the implementation of new products, group changes, benefit enhancements, non-standard benefits and activities related to mass updates.
• May assist with training new employees.
• Other duties as assigned or requested.
EDUCATION
Minimum
• High School Diploma/GED
Substitutions
• None
Preferred
• None
EXPERIENCE
Required
• 3 years of relevant, progressive experience in the area of specialization. Exempted experience requirements effective August 2016
Preferred
• Experience in health care, insurance or sales
LICENSES/CERTIFICATIONS
Required
• None
Preferred
• None
SKILLS
• Knows and applies principles, practices and processes within the specific field or discipline. Building higher-level knowledge and skills. Gathers and analyzes information, designs and tests solutions to problems, and formulates plans. • Performs work that is varied and somewhat difficult. Solves a range of problems by analyzing possible solutions using standard processes.
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 Never
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.
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.
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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