BPO New Business Processor/PCL Processor

Job Description
Processes and coordinates all plan benefit changes and required structural and administrative updates into systems essential for on-line viewing, claim enrollment and billing purposes.

Fundamental Components

• Analyzes and determines if products and services selected by customers are aligned with their benefit needs, and can be adequately supported by existing systems or operating platforms; additionally, seeks solutions and negotiates essential requirements in support of any non-standard plan selections.
• Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure.
• Completes timely and accurate set-up of complex account structure and detailed benefit plans in systems for multiple constituents in order to satisfy both internal and external deadlines for production – impacting a wide variety products and services; May perform additional plan sponsor administration functions.
• Reviews benefit provisions to ensure compliance with state and Federal legislative mandates; evaluation process may also include assessment of summary plan descriptions and other related documents prepared by the plan sponsor or third party.
• If required, communicates revisions essential for supporting and guarding the plan against any unintended liability.
• Monitors and manages internal installation process and maintains case tracking tools to meet constituents expectations and business goals.
• Prepares complex employer contracts, custom contracts and/or employee custom certificates of coverage.
• Completes required data input into performance measurement systems in support of key business and management initiatives. 

Background Experience

• Healthcare industry experience (Customer Service, Claims, and or Plan Build preferred)
• Detail oriented
• Highly organized
• Good communication skills
• Strong problem solving skills
• Strong team player
• Strong product knowledge

Additional Job Information
Product knowledge.Strong team player.Superior customer service skills.Ability to manage multiple priorities.Excellent verbal and written communication skills.Problem solving skills.Attention to detail and accuracy.Analytical skills.

Education
High School diploma, G.E.D. or equivalent experience

Percent of Travel Required
0 - 10%