What are the responsibilities and job description for the Senior Benefit Review Specialist position at KPH Healthcare Services?
Overview
Scope of Responsibilities: Works under direct supervision and follows standard procedures to accomplish assigned tasks related to the Implementation and Benefit Review Team.
Job Summary: Provides support to the Implementation Manager for all aspects of customer service, account management, quality assurance, and other administrative projects. The position will act as a lead role within Benefit Review and be a liaison to management and other organization leaders, while still performing the daily functions of a Benefit Review Specialist. These functions include, but are not limited to, assisting with the day-to-day operations of Account and Client Service Resources of ProAct and coordinating and implementing the setup/support of existing ProAct clients.
Responsibilities
- Act as the Benefit Review Team leader; facilitate regular meetings with all Benefit Review Specialists.
- Process and implement benefit changes and/or updates for existing ProAct clients in all appropriate systems.
- Oversee and perform testing for all new ProAct clients to measure benefit accuracy.
- Assist the Implementation Manager in coordinating the team’s audit strategy.
- Perform quality assurance audits on a regular basis to measure client satisfaction.
- Assist Account Resources with impact analysis review.
- Maintain client information integrity within all appropriate systems.
- Assist Customer Service Representatives in the resolution of customer service issues, requiring additional support, to ensure complete client satisfaction.
- Assist Account Resources in the resolution of customer service issues, requiring additional support to ensure complete client satisfaction.
- Coordinate, maintain, and manage the distribution of member mailings.
- Collect and maintain various team metrics, providing regular reporting to the Implementation Manager and other leaders, as necessary.
- Assist in facilitating and performing training sessions for both new and existing employees.
- Provide support to the Implementation Manager and/or the Account and Client Resources, as needed, when communicating with external business partners.
- Responsible for completing all mandatory and regulatory training programs.
- Perform other duties as assigned.
Qualifications
Education:
- Required: Minimum High School Diploma or GED
- Preferred: AS Degree or Higher in Business Administration, Marketing or related field
Experience:
- Required: Minimum 1year experience with the RxSense adjudication and reporting platforms
- Required: 2 years experience in Customer Service
- Preferred: 2 years experience with Health Care, Insurance, or related field
Compensation:
$22.00 - 24.00 per hour.
The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.
KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.
Salary : $22 - $24
