Company :United Concordia DentalJob 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
- Associate's Degree in Business Administration/Management
Substitutions
- 3 years of progressive related experience in lieu of Associate Degree
Preferred
- Bachelor's Degree in Business Administration/Management
EXPERIENCE
Required
- 3 - 5 years of Sales Support
- 1 - 3 years in Insurance
Preferred
- 1 - 3 years of Dental Sales experience
LICENSES OR CERTIFICATIONS
Required
- Producer's License - Accident & Health, or within 45 days of hire.
Preferred
- None
SKILLS
- Analytical Skills
- Communication 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
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$50,200.00
Pay Range Maximum:
$91,200.00
Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
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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Top Skills
What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms.
A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best.
Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia.
We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions.
We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.