Account Executive

The Account Executive is an essential role that is responsible for client implementation and retention. This position requires an experienced individual with prior account management experience as it relates to Group Health Plans. This position will work with all operational departments within PBA to ensure a great client experience. This position is also outward facing and reports to the Director of Client Accounts. Please see below for a more in-depth overview of daily responsibilities and skills required for this position.

Skills required for this position:

• Must be able to maintain a positive work atmosphere by behaving and communicating in a manner so that you get along with peers, subordinates, clients, vendors, and management.
• Must be a self-starter who is organized and able to handle multiple projects and due dates.
• Good problem solving and research skills.
• Proficient in Microsoft Office Suite products.
• Strong presentation and communication skills to large and small audience.
• Good understanding of benefit plans and government regulations, i.e., HIPAA, COBRA, ERISA, ADA, etc.

Responsible for:

• Oversee transition of new clients from prior administrator to PBA. Obtain all information related to company benefit plans and distribute to various departments as needed. Complete all external vendor set up paperwork.
• Complete internal documentation and participate in internal and external transition meetings as needed.
• Facilitate ongoing vendor file changes.
• Process requests for plan changes and group terminations. Distribute information to various departments as needed.
• Act as a primary contact for broker contacts.
• Liaison between PBA departments with clients, brokers, and vendors.
• Attend meetings, including, but not limited to:
  • Prospective clients
  • Current clients
  • Brokers
  • Employee open enrollment/re-enrollment
  • Health fairs
• Oversee broker and client monthly reporting including set up of initial reports and responding to requests for additional monthly reports.
• Assist brokers and clients with ad hoc report requests.
• Performing other duties as assigned to support PBA’s Mission, Vision and Core Values

Medical Claims Analyst

What we need from you

Technical Skills

• Strong claim knowledge/understanding.
• Proficient in Microsoft Office Suite products.

Soft Skills

• Must be able to maintain a positive work atmosphere by behaving and communicating in a manner so that you get along with peers, customers, clients, and management.
• Ability to work independently.
• Excellent organizational skills and attention to detail.
• Solid presentation, communication, facilitation, team building and decision-making skills.

What you'll be doing

Day to day

• Processing medical, dental and vision claims.
• Meeting monthly Quality and Production requirements.
• Maintaining assigned block of business with minimal assistance.
• Maintaining assigned block of business additional/priorities/CRM tasks in claims system with minimal assistance.
• Assisting on non-assigned block of business with minimal assistance.
• Advising Claims System Coordinators of incorrect benefit codes or any claim issues encountered when processing.
• Reviewing and responding to Member Advocacy e-mails within 48 business hours.
• Handling renewal groups/excess claims in a timely manner.
• Performing other duties as assigned to support PBA’s Mission, Vision and Core Values.

Member Advocate

What we need from you

Technical Skills

• Strong verbal communication skills along with being an active listener.
• TPA/Insurance Company environment or medical billing office experience preferred.
• Proficient in Microsoft Office Suite products.

Soft Skills

• Must be able to maintain a positive work atmosphere by behaving and communicating in a manner so that you get along with customers, clients, co-workers, and management.
• Must be a self-starter who is organized, sets priorities and manages time effectively.
• Ability to quickly learn and adapt to new concepts/systems.
• Ability to interface with various levels of the organization.

What you'll be doing

Day to day

• Handling inbound phone calls and provide quality customer service to callers.
• Placing follow up calls to members and providers.
• Responding to portals and e-mails.
• Maintaining a work knowledge of plan benefits.
• Suggesting process improvement ideas.
• Going the "Extra Mile" when necessary.
• Performing other duties as assigned to support PBA’s Mission, Vision and Core Values.

To Apply

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