Account Operations Services Manager
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Job Description
Remote Account Operations Services Manager supporting brokers, clients, claims, invoices, and stop-loss operations. Improving processes for Crumdale Specialty’s self-funded healthcare insurance solutions.
Responsibilities:
- Evaluate existing processes, document gaps, collaborate with appropriate teams, and implement solutions supporting channel partners and internal stakeholders
- Participate in process reviews to identify bottlenecks, understand the business environment, and build scalable solutions
- Resolve escalations requiring attention outside Account Management or stop-loss operations teams
- Support Account Management and Implementation teams for new and renewing brokers, customers, and members
- Develop technology solutions for systematically tracking activity impacting customers, brokers, and members
- Develop deep understanding of the company, represented companies, products, and services
- Track TPA and PBM invoices and follow up on significant outstanding accounts receivable
- Track vendor per-claim fees and address discrepancies with accounting and the TPA
- Track duplicate claims found during stop-loss audits and help ensure corrections with the TPA
- Monitor claims with specific thresholds and escalate for review when needed
- Support Account Managers with stop-loss denials by reviewing denied claims and communicating next steps to clients and brokers
- Engage with stop-loss carriers for non-implementation work
- Assist in training and orienting new employees on processes and documentation
- Complete other projects and needs requested by leadership
Requirements:
- Excellent customer service skills with a high level of customer focus, motivation and follow through, and confidence to engage with brokers and clients
- Ability to work in a fast-paced environment with excellent prioritization, project management, problem solving and time management skills
- Ability to work equally well autonomously and as part of cross-functional teams
- Excellent written and oral communication
- Strong analytical skills and attention to detail
- Proficient in Microsoft Office Suite (Outlook, PowerPoint, Word, Excel)
Benefits:
- Medical insurance
- Vision insurance
- Dental insurance
- 401(k)
- Disability insurance
- Flexible PTO
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