Job Title:Claims Processing Implementation Specialist

Department: Operations

Location: Alpharetta, GA area

Salary: 60k-80k (Bonus target of 5%)

About Us: FirstEnroll is a Third-Party Administrator (TPA) specializing in health insurance. We help streamline the process of selling and administering insurance products and act as an intermediator between Carriers, Agents, and Members. Our comprehensive services ensure seamless operations, allowing agents to focus on their clients. We are committed to innovation and excellence, setting new standards in the industry.

Key Responsibilities:

• Meet with customers and gather information that will aid in a successful Claims Processing implementation.
• Create a project plan for each customer, detailing the tasks that need completion for a timely launch.
• Partner with other departments to gather necessary information necessary for Claims product implementation.
• Organize daily activities based on the goals of the organization.
• Monitor deadlines and overall projects to ensure goals are met.
• Respond to customer submitted support requests, as needed.
• Share program/project/implementation status and goals with appropriate stakeholders.
• Provide training, where appropriate, during implementation.
• Provide after-implementation calls to review the project and identify any gaps that may exist.
• Communicate with clients throughout the Claims Processing implementation process to obtain feedback and approval.
• Customize software systems based on clients’ individual needs and specifications.
• Educate clients on how to use Claims systems and features.
• Creating a specialized document for each client, detailing all customizations made.
• Answer all product-related questions in a polite manner and address queries promptly.
• Maintain standard system formats.
• Build and update plan changes in Claims software system as they become available.
• Work collaboratively across multiple functional departments in the organization.
• Ensure data files are processed and loaded across multiple vendor partners.

Claims Processing Implementation Specialist Requirements:

• High school diploma or similar.
• Articulate and able to perform demonstrations that engage and inspire.
• Deadline-driven, and willing to work after hours.
• Sound technical knowledge.
• The ability to multitask effectively.
• Superb verbal and written communication skills, as well as great telephone etiquette.
• Ability to memorize details like product specifications.
• The ability to work independently and as part of a team.
• A strong growth mindset.