- Setup groups in the group and benefits administration systems, including medical, pharmacy, dental, and vision benefits.
- Communicate with Sales or Brokers to understand the client's benefits purchase and execute the setup.
- Manage internal processes, including but not limited to reviewing customer records for accuracy to process the groups, re-entry of improper input into the system and
- Understanding of corporate and departmental policies and procedures
- Responsible for making the determination, based on information gathered, that the case can be accepted and forwarded for processing, or requires further review
- Conform with the plans, policies, and procedures established by Sales management all Underwriting guidelines are met, rate quotes are correct, and determine if additional underwriting is required
- Determine that new clients meet new sale underwriting guidelines and set clients up in the system
- Understand renewal change requested by the client and execute change in the system
- Execute cancellations and maintenance of a group account
- Inform Enrollment and Billing teams of enrollment and billing actions needed
- Investigate and resolve client setup issues in core platform systems I
- Investigate and resolve pharmacy setup issues. Resolve access to care for members in the pharmacy benefit system
- Partner with benefit administration vendors to investigate and resolve issues
- Meet departmental production and quality requirements
- Prepare quality control documentation submitted to the processing areas for group set-up and changes
- Develop and maintain a strong business relationship with the internal customers of the IBC Family of Companies, including but not limited to, Underwriting, Sales,
- Marketing, Enrollment, Customer Service, and any other areas involved in the process.
- Responsible for broker setup. Connect the client groups to the correct broker in the broker commissions system.
- Resolve broker setup discrepancies and address the broker inquiries and concerns
- Research and resolve group setup issues for medical, pharmacy, dental, and vision benefits
- Resolve problems, identify trends, and educate customers as needed
- Perform quality audit of all documentation provided for group/customer set-up and coordinate missing materials when needed
- Audit all incoming materials and maintain complete documentation regarding issue resolution for broker community, external clients and the departments
- Handle errors and internal/external issues in a timely and effective manner to maintain turnaround times for completion of customer/group set-up
- Provide technical assistance and guidance to Sales and other areas relative to the new business enrollment process implementation of new groups, new customers, benefit changes, group structure and general customer issues
- Responsible for implementation of new groups, benefit changes and cancellations
- Understand customer requirements, document issues or tasks and work closely with Sales to meet customer expectations
- Research and troubleshoot benefits and any other issues related to group set-up
- Represent the Client Setup team in cross-functional internal and vendor meetings
- Perform additional duties as assigned
- Associate degree required, Bachelor's degree preferred, or must have 2-3 years relevant
- Excellent time management and organizational skills required. Ability to prioritize workload and meet
- Willingness to be cross trained is required to assist other team members.
- Strong communications skills required - position interacts with all levels of management and may communicate with external clients as well. Must be a strong problem-solver and be able to follow-up and take an issue to resolution.
- High level of technical aptitude required - ability to use Microsoft Office and to learn
- High level of professionalism is necessary to progress.
- Minimum 2-3 years relevant experience required
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Description
The Client Setup Analyst is responsible for setting clients up in the group setup and benefit administration system. This includes new sales, renewal changes, cancellations, and maintenance of the client's account setup. The Client Setup Analyst investigates and resolves client setup issues.Some critical thinking skills:
Capability to understand Underwriting guidelines and apply them.