Client Benefit Analyst

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

Substitutions

Preferred

EXPERIENCE

Required

Preferred

LICENSES OR CERTIFICATIONS

Required

Preferred

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

Lifting : up to 10 pounds

Constantly

Lifting : 10 to 25 pounds

Occasionally

Lifting : 25 to 50 pounds

Rarely

Pay Range Minimum : 50,200.00

Pay Range Maximum : 91,200.00

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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