Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.
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.
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.
Handle 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
resolution of any other operational or internal systems issues that may arise
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\Ensure 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 client up in the system
Understand renewal change requested by client and execute change in 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
nvestigate and resolve pharmacy setup issues. Resolve access to care for members in 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 in regard to 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 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
experience
Excellent time management and organizational skills required. Ability to prioritize workload and meet
deadlines in a fast paced environment with some supervision. Flexibility and adaptability is a must.
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.
Aptitude to understand benefits and Underwriting rating methodology. Some critical thinking skills; Capability to understand Underwriting guidelines and apply them.
High level of technical aptitude required - ability to use Microsoft Office and to learn
proprietary and vendor systems.
High level of professionalism is necessary to progress.
