Account Manager - Healthcare TPA
13 days ago
Fort Lauderdale
Job Description Job Title: Account Manager - Healthcare TPA Department: Sales Reports To: Vice President, Client Services Location: FL (Central) or GA (Greater Atlanta) About Heathos Heathos is transforming the healthcare insurance landscape through a connected, data-driven ecosystem that simplifies complexity and drives long-term success. Built on trust, innovation, and integrity, we provide technology, services, and insights that support agencies, carriers, and members at every stage. Our family of brands — FirstEnroll, AdminOne, and SonicMarketing — works together to streamline operations and deliver a seamless insurance experience. Role Summary The Account Manager serves as the primary point of contact between FirstEnroll (a healthcare TPA) and its clients, ensuring the smooth delivery of services while maintaining strong relationships. This role involves understanding client needs, providing timely support, resolving issues, and identifying opportunities for business growth. Key Responsibilities 1. Client Relationship Management • Act as the main liaison between clients (employers, insurers, or brokers) and the TPA., • Build and maintain strong relationships with key stakeholders, ensuring a high level of client satisfaction., • Conduct regular check-ins and meetings with clients to review performance, address concerns, and provide updates on services. 2. Account Management • Oversee the end-to-end administration of client accounts, including onboarding, plan setup, and policy renewals., • Ensure compliance with service-level agreements (SLAs) and timely resolution of client issues or escalations., • Monitor and analyze client utilization trends, claims data, and feedback to identify areas for improvement. 3. Service Delivery and Coordination • Collaborate with internal teams (claims processing, network management, customer service, etc.) to ensure seamless service delivery., • Provide training or education to clients and their employees on healthcare plans, claim processes, and benefits., • Coordinate wellness programs, health camps, or other initiatives as part of client engagement. 4. Business Development and Retention • Identify opportunities to expand service offerings, cross-sell, or up-sell additional TPA solutions to existing clients., • Assist in preparing and delivering proposals or presentations for contract renewals., • Work to retain accounts by proactively addressing potential client dissatisfaction and presenting value-driven solutions. 5. Reporting and Compliance • Prepare and deliver periodic performance reports, claims analysis, and utilization summaries to clients., • Ensure all activities and communications comply with relevant healthcare regulations and industry standards., • Keep records of client interactions, agreements, and feedback in the CRM system. 6. Industry Expertise • Stay updated on industry trends, regulations, and best practices in healthcare and insurance., • Provide insights and recommendations to clients based on market developments. Qualifications • Bachelor’s degree in healthcare administration, business, or a related field., • 3+ years of experience in account management, client servicing, or a related role, preferably in the healthcare or insurance industry., • Familiarity with TPA operations, health insurance policies, and claims processes is a plus., • Current licensed agent experience., • Proficiency in CRM tools and MS Office Suite (Excel, PowerPoint, Word). Skills and Competencies • Strong interpersonal and communication skills, with the ability to build rapport and trust., • Excellent organizational and time-management abilities to handle multiple accounts effectively., • Problem-solving skills with a focus on delivering client-centric solutions., • Analytical skills to interpret data and trends, providing actionable insights., • Ability to collaborate across teams and manage cross-functional relationships., • Knowledge of healthcare benefits, claims processing, and insurance products is preferred. Key Performance Indicators (KPIs) • Client satisfaction score (NPS or equivalent)., • Retention rate of client accounts., • Timeliness and quality of service delivery., • Growth in revenue from existing accounts., • Resolution time for client issues and escalations. Heathos is proud to be an equal opportunity and affirmative action employer. We are committed to building a workforce that is representative of the agencies, carriers, and members we serve, creating a culture of belonging, and providing an equal employment opportunity regardless of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, criminal histories consistent with legal requirements, or any other basis protected by law. See also Know Your Rights: Workplace Discrimination is Illegal. If you have a need that requires accommodation, please let us know here. Heathos is a binational company and, in order to facilitate efficient collaboration and communication binationally, English proficiency is a requirement for all roles unless stated otherwise in the job posting.