Account Representative

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Showing 1 location

Omaha
Omaha, NE 68164, USA

• Full-Time

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

Work with external broker distribution channel supporting new and renewing small group Commercial business, providing guidance on regulatory requirements, processes, products and value adds available. Provide service on enrollment, billing and claims issues. Performs other duties as assigned.

The Account Representative is a small group business specialist with expertise in Medica’s products, pricing, sales guidelines, and operational processes. The incumbent partners with the Agency Relationship Managers to provide consultation and education to Medica’s broker distribution channel on all aspects of Medica’s small group business. The incumbent has on-going interaction with the broker channel to quote, install, retain and service our small group fully and self-insured business.

The Account Representative has significant interaction, collaboration and negotiation with functional content specialists across all operations to address client questions and demands. This position is critical for client satisfaction and the ability to retain the business relationship with Medica.

• Manage an assigned portfolio of small group accounts.
• Prioritize workload, monitor account activity, and maintain accurate account documentation.
• Build and maintain strong relationships to support retention and client satisfaction.
• Research, coordinate, and resolve escalated service issues.
• Manage inquiries related to eligibility, billing, enrollment, claims, and benefits.

• Bachelor's degree or equivalent combination of education and experience required
• Relevant experience could include, Customer Service, Vendor Management, Account Management, Group Health, Benefits Administration, Human Resources, etc.
• Demonstrated proficiency in working with both fully insured and self-funded health plans preferred
• Experience working with brokers preferred

• Ability to gain thorough knowledge of federal/state regulations and Medica’s requirements related to small group validation as well as the requirements for submission
• Strong interpersonal, relational skills in the management of client service
• Excellent written and verbal communication skills
• Ability to negotiate successful outcomes with client
• Ability to work independently
• Self-driven, motivated and results oriented

This position is an Office role, which requires an employee to work onsite at our Omaha, NE office, on average, 3 days per week.

The full salary grade for this position is $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. Annual salary range placement will depend on a variety of factors…