Insurance claims processing jobs in Atlanta, GeorgiaCreate job alerts

The Strategic Account Executive position directly supports and leads the service and strategy for a diverse book of TPA and Multi-Employer clients. The SAE engages during the after-sales phase of the business; then after go-live, assumes complete responsibility of maintaining an extremely positive relationship with our clients. These positions may work remotely or in our Birmingham, AL headquarters, and requires up to 50% travel. Essential Job Responsibilities Include: * Develop and maintain effective working relationships in liaison role with Pharmacy Operations, service partner contacts (such as underwriters, brokers, PBMs, sales and service representatives) and client contacts. * Proficiently know marketplace, carriers, underwriting requirements & the benefits/services they offer. * Keep other Account Managers, Service Representatives, Directors, Vice President - Account Management and Vice President Business Development fully informed of all important activities on client accounts * Participate in development sessions and seek learning for skill and knowledge development. * Owns and oversees contracts are fully executed on an annual basis. Responsible for assisting TPA/MEO/Consultants with questions regarding all legal documents. * Maintain Strategy Plans for book of clients and work collaboratively across internal teams to advocate for client retention, client satisfaction and client needs. * Stays abreast of industry and competitive activities and updates account plans appropriately. * Quality check of applications (service agreements), claims processing and audit benefit designs, financial reports, etc * Owns the At-Risk clients and the At-Risk process and provides weekly updates via Salesforce and to management. * Assists Account Manager with Preparing and obtaining employee materials and present employee benefits via webinars, benefit fairs, face-to-face enrollment meetings and enroll employees in the appropriate services in a timely manner. * Assist in the communication of benefits in enrollment meetings, webinars with client and PBM companies * Act as liaison in conjunction with Pharmacy Operations, between client, brokers and PBM companies in order to independently resolve all service problems. Specifically, assist the client in resolving billing, claim, eligibility, COBRA and customer service problems. * Independently manage, with input from Service Representatives, Client Implementation, booklets, enrollment kits, enrollment forms, letters and checklists * Prepare and assure accuracy on audits, census data and quoting. * Make regular service/relationship calls to clients including client visits, recurring calls, and strategy and planning sessions. * Preparation of reports deemed necessary by the Account Management leadership. * Assists Account Manager with keeping all information on accounts accurate and up to date. * Grow and maintain existing client relationships as identified collaboratively with Business Development (Sales team) * Communicate to our clients "Our Value Added Service." * Meet or exceed departmental goals established by Account Management leadership. * Assist with keeping department materials, contacts, intranet, etc. up to date. * Assist with the development of job aids, training materials, etc * Present a positive image in and out of the office to fellow employees, members, providers, and the community * All other duties as assigned Required Skills / Experience: * High School diploma is required. Associate's or Bachelor's degree preferred. * 5+ years related industry experience and/or training. * Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook) * Thorough knowledge of Employee Benefits insurance. Ability to read, analyze and interpret industry policies and contract documents. * Excellent presentation and communication skills. * Strong analytical and critical thinking skills. * Strong organization skills with the ability to prioritize in a dynamic environment. * Self-motivated with the ability to work independently with limited supervision or within a group or team. Based on relevant market data and other factors, the anticipated hiring range for this role is $88,000 - $110,000 annually. Final compensation rates will be determined based on various factors, including but not limited to experience, skills, knowledge, and internal equity considerations. This role is also short-term incentive eligible with a target of 20% of base salary. Incentive award amounts will vary by individual and business goals. We are committed to fair and equitable compensation practices. The final salary offered to the selected candidate may vary from the posted range due to individual qualifications. Our goal is to ensure that all teammates are compensated fairly and competitively based on their contributions to our organization. RxBenefits is also committed to providing best in class benefits to our teammates. We offer a robust total rewards package that includes: * Remote first work environment * Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members * Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision) * Additional buy-up options for Short- and Long-Term Disability and Life Insurance * 401(k) with an employer match up to 3.5% available after 60 days * Community Service Day to give back and support what you love in your community * 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like * Reimbursements for high-speed internet, we'll send you a computer and monitors to help you do your best work * Tuition Reimbursement for accredited degree programs * Paid New Parent Leave that can be used for adoption or birth * Pet insurance to protect your furbabies RxBenefits provides equal opportunities for everyone who works for us and everyone who applies to join our team, without regard to sex or gender, gender identity, gender expression, age, race, religious creed, color, national origin, ancestry, pregnancy, physical or mental disability, medical condition, genetic information, marital status, sexual orientation, any service, past, present, or future, in the uniformed services of the United States (military or veteran status), or any other consideration protected by federal, state, or local law.

TRCTalent is working alongside a leading data center firm that is seeking a full time Risk Management, Sr Manager at their corporate office in Buckhead. Candidate must have bachelor's degree, CCIP knowledge and experience in construction/insurance. The Sr Manager, Risk Management is responsible for the development, implementation and maintenance of an environmental health and safety management system to ensure a safe, healthy workplace for employees and a safe, learning environment for students and visitors. Administers, plans, monitors and coordinates risk management activities, workers compensation, loss control and claims administration functions. Oversees emergency response programs and coordinates vendor insurance requirements and compliance. Responsibilities Conducts site assessments, reviews and self-inspections. Analyzes and interprets results, recommends appropriate corrective actions, communicates results and follows up on issues or concerns until completion Develops, implements, and maintains policies and procedures ensuring adherence to local, state, and federal environmental, health and safety regulations. Keeps abreast of changes to laws and regulations that impact the organization. Serves as a contact with federal, state, and local regulatory bodies. Responsible for conducting and evaluating periodic safety, fire and/or hazardous conditions or substance inspection of all company facilities, equipment and employee work practices; recommend changes and coordinates implementation. Tracks and oversees all Contractor-Controlled Insurance Programs (CCIP)s. Interprets insurance coverages and communicates policy and procedure changes to appropriate users. Serves as a resource for all risk management related issues for risk and insurance issues in all activities. Designs, directs and coordinates risk programs of company to control exposures and minimize loss. Responsible for the claim filing process for property and liability incidents. Prepares bid specifications and participates in the selection process. Reviews and updates policies, programs, and procedures ensuring inclusion of any new legal requirements. Reviews and investigates accident/incident reports, compiling findings and recommendations for corrective actions into summary report. Participates in shared governance process as a task force member. Provides technical knowledge on health and safety related issues, plans, and projects for implementation. Assists with the design and development of facilities, work areas and work procedures and ensures the implementation of environmental, health and safety requirements accordingly. Completes duties and responsibilities in compliance with firm standards, policies and guidelines. Uses interpersonal skills and makes sound judgments to decide how duties and responsibilities are completed between coworkers, the supervisory chain, and customers. Completes all required training and professional development sessions sponsored by firm Supports the values and institutional goals as defined by firm. Participates in the development of outcomes, monitors assessment of those appropriate outcomes, and assists in the development of plans of action for improvement based on the assessment of those outcomes. Performs other duties as assigned Qualifications Education And Experience Five (5) years of experience in safety, industrial hygiene, hazardous waste operations, and/or emergency response/incident management, safety administration, and/or general insurance administration. Risk Management Certification. Knowledge, Skills, Abilities, And Competencies To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Knowledge of safety, health, and environmental engineering principles and practices. Knowledge of federal, state, and local regulations and national standards relating to applicable areas of Environmental Health, including DOT, OSHA, HAZMAT, and NFPA. Knowledge of safety system, risk minimization, and insurance provisions. Knowledge of standard concepts, practices, and procedures within the Environmental Health and Safety field. Ability to maintain an established work schedule. Demonstrated organizational and planning skills with attention to detail and follow through. Ability to apply regulatory requirements to ensure compliance. Ability to apply technical expertise, experience, and judgment to plan and accomplish goals. Ability to maintain confidentiality of work related information and materials. Demonstrated proficiency using standard office software applications. Demonstrated excellent written communication and interpersonal skills, with ability to work independently. Proficient in the use of e-mail, word processing, spreadsheet, database, and presentation software and use of the Internet to access data, maintain records, generate reports, and communicate with others. Ability to handle sensitive and extensive confidential data. Problem solving skills and the ability to lead, instruct, handle a large variety of details and to work with all levels of organization. Ability to perform and excel in a high-tech all-digital environment.