Healthcare Account Associate

Job title: Healthcare Account Associate

Remote | Travel to Bethesda, MD approximately 35%

Healthcare / Health Insurance Claims

$75,000 - $90,000 / Annually

This position is eligible for medical, dental, vision, life insurance and 401k.

Addison Group is partnering with a growing healthcare organization seeking a Healthcare Account Associate for a newly created client-facing claims role. This position combines healthcare claims expertise, reporting and analytics, and account management.

The Healthcare Account Associate will manage healthcare claims activity while serving as a key liaison between internal teams and external clients. The ideal candidate has a strong technical claims background but is equally comfortable leading client conversations, reviewing reports, and explaining complex claims information.

• Track and process healthcare and Stop Loss claims through resolution.
• Review claims for eligibility, accuracy, duplicate charges, and reimbursement requirements.
• Monitor payment activity and ensure funds are appropriately issued to providers.
• Prepare client and Stop Loss aggregator reports.
• Lead client meetings to review claims, charges, and outstanding items.
• Utilize dashboards and reporting tools to analyze claims activity.
• Work with TPAs and other partners to resolve discrepancies.
• Collaborate with internal leadership and external clients.

• 5+ recent years of progressive health insurance claims experience.
• 3+ recent years of first-dollar health insurance claims processing experience.
• TPA experience required.
• Strong knowledge of claims processing, adjudication, and reimbursement.
• Experience utilizing WEX, Power BI, Excel, Salesforce, or similar reporting/dashboard tools.
• Stop Loss claims experience strongly preferred.
• Strong client-facing, presentation, and relationship management skills.
• Must be comfortable translating technical claims information for clients and leadership.
• Flexible, trainable, and confident working with executive-level stakeholders.

• Direct hire opportunity.
• Primarily remote with approximately 35% travel to Bethesda, MD, particularly during initial implementation.
• Business travel is company-paid.
• Must be available during core 9:00 AM–4:00 PM EST hours.

• Primarily remote position.
• Company-paid travel.
• Highly visible, client-facing position.
• Opportunity to help build and shape a newly created function.
• Unique combination of claims, analytics, technology, and account management.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran, in accordance with applicable federal, state, and local laws. Reasonable accommodation is available for qualified individuals with disabilities upon request.

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