The Account Supervisor is responsible for building and maintaining positive working relationships with our new and existing clients to ensure customer satisfaction and promote customer retention. This position requires the candidate to be detail oriented, professional and well-spoken to ensure all written and verbal responses are concise and accurate.
Primary Responsibilities
Establish effective working relationships with our customers
Act as the primary point of contact between MagnaCare and our clients
Provide accurate and timely responses to all client inquiries including written correspondence and/or verbal requests
Effectively communicate with clients, providers and members verbally and in writing
Capture and document all client interactions into our internal tracking system
Advanced claim processing including professional, facility and ancillary claims
Investigate claim payment/pricing inquiries upon client’s request
Apply medical policy, contractual provisions and operational procedures to ensure accurate adjudication and/or adjustment
Generate and analyze reports to identify root cause analysis of client payment issues
Ability to identify negotiation solutions and resolve conflicts in a manner that will ensure client and satisfaction
Perform as a liaison between internal contacts and our clients
Manage eligibility and COB issues
Prepare detailed cases for 2nd Level Appeals
Essential Qualifications
Bachelor’s Degree preferred
1+ years claims adjudication experience
Advanced claims processing including professional, facility and ancillary claims
Comprehensive knowledge of health care customer service
Excellent communication skills, both oral and written
Strong attention to detail and ability to self-check work
Excellent time management skills
Task oriented, excellent organizational skills, ability to prioritize work load
Enthusiastic attitude, cooperative team player, adaptable to new or changing circumstances
Excellent problem-solvingskills
Ability to prioritize, multitask and work independently on tasks
High level computer literacy and technical competence
Ability to collaborate with multiple parties, both internal and external to solve problems
Establish and maintain positive and effective work relationships with clients, coworkers, members, providers and customers
About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.
Come be a part of the Brightest Ideas in Healthcare™.
Company Mission
Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.
Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
DEI Purpose Statement
At BHPS, we encourage all team members to bringyourauthentic selves to work with all ofyourunique abilities. Werespect how you experience the world andwelcome you to bringthe fullness ofyourlived experience into the workplace. We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.
We are an Equal Opportunity Employer
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to:recruiting@brightonhps.com
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Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Sales and Business Development
Industries
Internet Publishing
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