Accounting Client Associate

PBA’s Accounting Client Associate will be responsible for preparing client billings, processing daily check cycles, managing and maintaining accurate records, ensuring compliance and supporting accounting functions within the team. This position will require the individual to be flexible, detail-oriented, and handle additional responsibilities as they arise with success and accuracy. This individual will report to the Accounting Client and Billing Manager. Below is a more detailed overview of daily responsibilities and skills required for this position.

Responsibilities

• Prepare client monthly billings
• Audit invoices and funding reports
• Process client check cycles
• Create and distribute clients funding requests to authorize check run cycles
• Process direct deposit and ACH transfers
• Routing of payments
• Maintain and improve accounting systems and processes
• QuickBooks posting
• Support the maintenance of general ledger, and ensure all financial transactions are accurately recorded
• Other duties as assigned

Requirements for this position

• Bachelor’s/Associates degree in Accounting, Finance, or a related field (preferred)
• 3–5 years of experience in financial accounting or a similar role
• Strong knowledge of accounting principles and financial reporting
• Proficiency in accounting software (QuickBooks)
• Excellent analytical and problem-solving skills
• High attention to detail and accuracy
• Strong organizational and time management abilities
• Effective communication and interpersonal skills
• Experience with prior claims system (Javelina preferred)
• Experience in third-party benefits administration preferred
• Knowledge of data analytics tools and Excel modeling

Benefits and Compensation

• PBA offers a comprehensive benefit package to include medical, dental, vision, life insurance, critical insurance, accident insurance, disability and 401k
• This role has a compensation range of $25.00 to $30.00 per hour based on prior experience and knowledge

Director of Operations

The Director of Operations will be accountable for the Claims, Claims Acquisition, Enrollment, and Member Advocate teams working with PBA’s leadership team to set the course for PBA’s future. Must be an outgoing business leader who can observe, analyze, and continually improve the operation to ensure it runs as efficiently as possible for PBA's success. This role reports to the COO/Integrator. Please see below for a more in-depth overview of daily responsibilities and skills required for this position.

Responsibilities

• LMA (Lead, Manage and support a culture of Accountability) using the EOS model to continually develop future leaders.
• Developing, mentoring, and evaluating Operations staff including, but not limited to, annual reviews and Quarterly Conversations.
• Oversight and accountability of the entire Operations team which includes:
  • Member Advocacy (Customer Service)
  • Claims Acquisition
    • Claims Prep
    • PPO Liaison
    • Provider Maintenance
    • Mail Room
  • Enrollment
  • Claims
    • Claims Processing
    • Training/Auditing
    • Excess stop loss claims
    • Plan Loading
    • Medical Management navigation between PBA and UR Vendors
• Vendor management/documentation
• Strategic Planning: Develop and implement operational strategies that support overall business objectives.
• Process Improvement: Analyze and refine business processes, workflows, and policies to boost efficiency and performance.
• Financial Management: Manage operational budgets, control costs, and monitor financial performance metrics.
• Leadership & Supervision: Lead teams, set guidelines for staff, and foster cross-functional collaboration.
• Performance Monitoring: Track key performance indicators (KPIs), analyze data, and report on operational health to executives.
• Accountability: Holds departments accountable for goals, tracks metrics, ensures follow-through, and drives results.
• Resource Management: Oversee production, inventory, vendor relationships, and resource allocation.
• Reporting department activity to COO/Integrator on a weekly basis.
• Applying observations and feedback to continually improve PBA’s operation.
• Other duties as assigned.

Requirements for this position

• 7+ years managing, coaching, and directing larger teams in a similar service based or claims operation.
• 5+ years managing Third Party Administration Claims processing.
• Ability to travel for quarterly meetings and/or client engagements when necessary.
• Stoploss experience or knowledge a strong plus.
• Javelina claims system experience or knowledge a strong plus.
• Senior level organizational, analytical and accountability skills are necessary.
• Effective verbal and written communications.
• Demonstrated ability to get results through team members and management.
• Adaptability to new concepts and systems.
• Problem solver and critical thinker.
• Open minded with a desire to learn, grow and receive feedback in a welcoming way.
• Must be able to represent PBA’s Core Values and business procedures to vendors, brokers, and clients.

Benefits and Compensation

• PBA offers a wide range of benefits including medical, dental, vision, life insurance, AD&D, critical illness, accidental illness, FSA, disability and 401k.
• The range for this role is $175,000-$190,000 per year.

Mountain Time (MST) Member Advocate

The Member Advocate is responsible for providing excellent customer service to our members and providers. Primary focus will be supporting those in mountain and central time zones. This position requires strong communication skills, problem solving, and overall client satisfaction. This individual reports to the Member Advocacy Manager. Please see below for a more in-depth overview of daily responsibilities and skills required for this position.

Responsible For

• 50+ incoming calls per day to provide quality customer service to callers.
• Developing and maintaining problem solving skills and troubleshooting abilities for the purpose of assisting callers and going the “extra mile” when necessary.
• Accurately identifying callers needs, conducting research and assisting with issue resolution.
• Provide clear communication with focus on empathy and professionalism.
• Referring to any claims or issues that require adjustments, processing, repricing, or other intervention according to guidelines.
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems.
• Own issues through to resolution on behalf of the member in real time or through comprehensive and timely follow-up with the member.
• Responding to portals and all e-mails timely.
• Placing follow-up calls to members and providers, timely.
• Maintaining a working knowledge of plan benefits.
• Suggesting process improvement ideas.
• Presenting problems/trends to Management.
• Performing other duties as assigned to support PBA’s Mission, Vision and Core Values.

Skills Required for this Position

• 2+ years in a customer service-oriented role which required communicating over the phone.
• Maintain a positive work atmosphere by behaving and communicating in a manner so that you get along with customers, clients, co-workers, and management.
• TPA/Insurance Company environment or medical billing office experience preferred.
• Customer focused and adaptable to different personality types.
• Multitask with numerous customer service computer screens.
• Excellent typing skills, clearly documenting call notes.
• Active listener and provide empathy and understanding to callers.
• Strong verbal communication and interpersonal skills.
• Ability to quickly learn and adapt to new concepts/systems.
• Professional and responsible work ethic.
• Ability to interface with various levels of the organization.
• Proficient in Microsoft Office Suite products.

Essential Functions Statement

• This role is a remote role requiring the individual to have a private, dedicated space free from distractions.
• In this position you must be able to exchange accurate information/communication with co-workers, customers and vendors.

Benefits and Compensation

• PBA offers a wide range of benefits including medical, dental, vision, life insurance, AD&D, critical illness, accidental illness, FSA, disability and 401k.
• The range for this role is $23-$25 per hour

Physical Demands

• This is largely a sedentary role which requires the ability to sit for long periods of time.
• The person in this position constantly operates a computer.
• To perform the physical requirements of the position, the employee must be able to have manual dexterity in his or her hands in order to keyboard; see; hear, talk, sit; and stand.

Team Lead- Operations Claims Acquisition

The Team Lead is responsible for assisting the Claims Acquisition Manager in overseeing daily departmental workflow, ensuring productivity, quality, and efficiency while fostering a positive and collaborative work environment. This role serves as a key liaison between staff and management, providing leadership, support, and direction to ensure departmental goals are achieved in alignment with the organization’s mission, vision, and values.

Responsibilities

• Assist the Claims Acquisition Manager by monitoring workload distribution and rebalance assignments based on team strengths and business needs.
• Communicate work-related updates, challenges, and performance metrics to management.
• Assist with departmental tasks and projects as needed to support operational goals.
• Perform pre-log data entry of faxed documents and securely store files on the shared drive.
• Pre-log claims across multiple lines of business, including Level I, II, III, Dental, and Pharmacy (Rx).
• Audit incoming electronic claims to ensure accuracy and completeness.
• Maintain and update provider information within the claims management system.
• Investigate and resolve undeliverable mail through research and appropriate follow-up actions.
• Manage and complete assigned work queues in a timely and efficient manner.
• Provide onboarding, training, and continuous development for team members.
• Clearly communicate and enforce departmental expectations, policies, and performance standards.
• Identify opportunities for process improvement and present innovative ideas to enhance efficiency and service quality.
• Perform other duties as assigned.

Requirements for this position

• Minimum of 3-5 years of experience in a Team Lead role or SME in TPA claims intake.
• 3+ years of experience in TPA operations, with demonstrated knowledge of claims intake processes, system workflows, quality controls and the ability to identify and resolve complex claim or data issues.
• Demonstrated ability to meet performance goals while maintaining a high level of customer satisfaction.
• Excellent problem-solving skills, with the ability to anticipate challenges and implement effective solutions.
• Strong verbal and written communication skills.
• Highly organized, self-motivated, and capable of managing multiple priorities and deadlines.
• Ability to collaborate and interface with employees, management, clients, and stakeholders.
• Sound judgment and confidence when coaching and developing employees.
• Effective conflict resolution and decision-making abilities.
• Proficiency in Microsoft Office, with an emphasis on Excel.
• Strong commitment to punctuality, attendance, and reliability.

Essential Functions Statement

• The person in this position must demonstrate strong attention to detail to be able to properly maintain various reports and documentation, and coordinate system setups and networks.
• The role is a remote role, dedicated space and high-speed internet required.

Benefits and Compensation

• PBA offers a wide range of benefits including medical, dental, vision, life insurance, AD&D, critical illness, accidental illness, FSA, disability and 401k.
• Hourly compensation for this role is $25-$29 based on prior experience (and meeting required skills)