TPA (Third Party Administrator) Healthcare Account Executive - NON-SALES

Covenant Administrators, Inc.

Job Description

 

Job Title:  Third Party Administrator (TPA) Healthcare

Account Executive ? NON-SALES

Department:    Covenant Administrators/Client Services

Reports To:  Manager ? Administration/Client Services

FLSA Status:    Exempt

Salary Range: $40K ?  $55K, dependent of level of experience.

Relocation:  Negotiable

 

JOB SUMMARY:This position acts as a liaison between the client,

 broker and internal customers in the area ofthird

 party administration of Health & Welfare benefits to

 client companies.

 

 PRIOR EXPERIENCE IN THE HEALTH INSUR- ANCE INDUSTRY IS A MUST - EXPERIENCE

 WITH THIRD PARTY ADMINISTRATION IS

 HIGHLY DESIRABLE.



 

ESSENTIAL DUTIES & RESPONSIBILITIES:

 

?Implements new clients which consists of holding implementation meeting with client, new case meeting with internal staff, setting up vendors, eligibility, id cards and all items necessary to have new case up and running by effective date. 

? Maintains renewal process on all existing clients on a monthly basis.

? Provides service to clients via fax and phone calls on a daily basis, both incoming and outgoing.

? Create, proofread and revise plan documents on an as needed basis.

? Maintain all contract and correspondence files for each client.

? Coordinate all contract material for signatures, between client, broker and appropriate vendors. Make sure enrollment, ID card, plan documents and claim payments begin on a timely basis (new and existing clients).

? Handle all contract changes which result in an amendments, on a on-going basis.

? Assist clients with employee meetings to answer benefit and eligibility questions.

? Handles special reporting requests.

? Assists in implementing new products for clients.

? Other duties as assigned.

 

SUPERVISORY RESPONSIBILITIES:  none.

 

QUALIFICATIONS:

 

?Strong knowledge of self-insured plans is essential

?Knowledge of contracts, both verbal usage and written

?Strong customer service personality

?Ability to ?change gears? quickly and ?to think on your feet? is imperative

?Must be able to interact with other departments and respond quickly to customer requests.

?Ability to do some local travel, some overnight travel may be involved

?To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



EDUCATION and/or EXPERIENCE:

 High School or GED required. Some College or Undergraduate degree in a Health Care Management field, desirable. Five years of work experience in related field accepted in lieu of college.

 

LANGUAGE SKILLS:

 Strong communication skills essential, both written and verbal.

 

MATHEMATICAL SKILLS:

 Basic mathematical skills essential

 

REASONING ABILITY:

 

? Strong reasoning ability is essential.

? The ability to work with deadlines and renewal periods, essential

 

CERTIFICATES, LICENSES, REGISTRATIONS: n/a.

 

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

? Ability to sit for long periods of time

? Ability to lift 10 to 15 lbs.

 

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

? Basic office cubicle environment, low to moderate noise levels.