TPA Account Manager
hace 3 días
Lafayette
Job DescriptionDescription: Collabrios delivers purpose-built software solutions that unify the entire care journey. With decades of expertise in Programs of All-Inclusive Care for the Elderly (PACE) and deep industry knowledge, we empower care providers to streamline operations and deliver exceptional care to aging adults. Our integrated SaaS platform includes Electronic Medical Records (EMR), Third-Party Administrator (TPA) financial services, and care coordination solutions, helping PACE programs optimize workflows, ensure compliance, and enhance overall operations. We partner with PACE, government agencies, and community-based organizations to advance care delivery and improve outcomes for the communities they serve. Job Overview The TPA Account Manager (AM) serves as a key liaison between PACE organizations and Collabrios’ TPA services. In this role, you’ll build and maintain strong client relationships, coordinate operational activities, and identify opportunities to improve client outcomes. Working closely with the Account Management team and cross-functional departments, you’ll address client needs, develop solutions, and ensure all deliverables are met on time and in compliance with regulations. This position is integral to client satisfaction, operational efficiency, and long-term partnership success. Key Responsibilities • Client Relationship Management: Prepare and maintain active project plans for assigned clients, providing regular updates during scheduled calls and meetings., • Reporting & Compliance: Coordinate the submission of required reporting for clients and internal management to meet critical deadlines. Ensure all reporting meets regulatory and contractual requirements., • Risk & Quality Oversight: Perform risk assessments, quality reviews, and monthly reporting as directed., • Operational Problem-Solving: Identify and resolve challenges in claims processing, payments, enrollment, and provider contracts. Recommend and implement solutions in collaboration with internal teams., • Implementation Support: Participate in pre- and post-implementation calls to ensure smooth onboarding and ongoing client satisfaction., • Cross-Functional Coordination: Work with internal teams to address client requests or concerns, and identify opportunities to enhance service offerings., • Outreach & Communication: Manage phone and email outreach to clients, and conduct follow-ups as needed to ensure open communication and alignment., • Regulatory Reporting: Coordinate and submit regulatory reports to governing agencies or internal leadership to meet all deadlines., • Data Reconciliation & Management: Assist with data entry, reconciliation, and analysis to support reporting and compliance submissions., • Documentation & CRM Management: Maintain up-to-date client information, meeting notes, and follow-up actions in CRM systems., • Regulatory Compliance Tracking: Monitor and track changes to regulations, ensuring updates are incorporated into internal policies and procedures. Required: • 3–5 years of experience in account management, client services, or a related role, • Minimum of 3 years of health insurance experience, • Knowledge of Medicare, Medicaid, and PACE programs, • Strong understanding of provider contracts and ability to analyze terms, • Proficiency with Microsoft 365 and ability to adapt quickly to new systems, • Strong communication, problem-solving, and relationship-building skills, • Analytical skills for interpreting client data and identifying insights, • Ability to prioritize workload, manage multiple clients, and meet deadlines, • Time management and multitasking skills in a fast-paced environment, • Ability to work independently with minimal supervision, • Prior Third Party Administrator (TPA) experience At Collabrios Health, we’re committed to fostering a workplace that supports your well-being, growth, and ability to make a meaningful impact. Here’s what you can expect when you join our team: • A connected, virtual-first culture with a collaborative, mission-driven team, • Competitive health benefits, including medical, dental, and vision coverage, • 401(k) with company contribution, • Generous paid time off, including 15 PTO days, 2 floating holidays, and 6 sick days, • Flexibility and trust—we empower our team to manage their schedules and work in ways that support their lives, • Opportunities for learning, mentorship, and professional development Collabrios is an equal opportunity employer. We welcome candidates from all backgrounds, identities, and experiences. If you’re excited about this role but your experience doesn’t align perfectly with every qualification, we encourage you to apply anyway. You may be the right candidate for this or other roles.