Client Benefit Analyst
Highmark HealthAbout the role
Company :
United Concordia DentalJob 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 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
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.
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