Account Relationship Specialist I

Account Service Representative

In-office service contact for assigned groups. Handles day-to-day servicing inquiries directly with account contact via e-mail and phone.

Assist with coordination of GTB and certificate requests.

Validate the Summary of Benefits Coverage (SBCs), Benefit Summaries, and Summary of Changes that all accurately reflect what the group contracted for and ensure that employer group SBCs are sent out timely in accordance with Federal regulations.

Prepare and submit documentation of accepted renewal rates and benefit changes (if applicable) for system updates. Verify that rates and benefits submitted are reflected accurately in HMSA's QNXT system.

Assist with activities associated with Open Enrollment and the new group on-boarding process as assigned. Work with internal HMSA departments to answer account questions and resolve issues as needed. i.e.- Membership, Customer Relations

Screen delinquency report monthly and work under the guidance of the account manager to determine when proactive outreach to selected employers who are past due is necessary, or to request exceptions when justified. Follow up with actions to avoid negative impact on the group's employees.

Review retroactive transactions and work under the guidance of the account manager to determine whether an exception is warranted. Research claims paid and uncovered any special circumstances which may affect exception decision.

Assist with researching, processing and following up on inquiries from employer groups.

Meet assigned goals for customer retention, servicing standards, customer survey and other key performance metrics as defined.

Work in collaboration with cross functional team consisting of Strategic Account SAM, ARC, ARS I and HPA. This includes attending team meetings to plan various account servicing activities, appropriate escalation of issue, accepting delegated work from members of the team, and serving as the in-office contact for field-based team members needed assistance while in the field.

Assist in implementing proactive sales and servicing strategies

Back up for ARS team members and account teams.

Associate's degree and two years progressively responsible work experience, or equivalent combination of education and/or related work experience.

Strong verbal and written communication skills

Intermediate working knowledge of Microsoft Office applications, including but not limited Word, Excel, Outlook, and PowerPoint.

Hawaii Medical Service Association