Client Relationship Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the primary point of contact for all personnel of the designated client and their Human Resources department.

• Manage member and HR service inquiries from the point of initial contact to resolution.

• Address employee queries concerning benefits, claims status, Explanation of Benefits (EOBs), eligibility, prior authorizations, billing, and other plan-related inquiries via phone and email.

• Investigate and resolve escalated or complex claims and benefit-related issues.

• Collaborate with Claims, Eligibility, Stop Loss, Accounting, Account Management, Operations, and external plan vendors.

• Provide education to HR contacts and employees regarding plan benefits, administrative procedures, claims processes, available resources, and best practices.

• Foster and maintain relationships with the client's HR team and employees while advocating within ABA.

• Identify recurring claims or service challenges and escalate potential processing trends or systemic issues.

• Acknowledge inquiries within 24 business hours and supply resolutions or status updates within 48 business hours.

• Participate in Open Enrollment meetings, benefit fairs, and other client-facing events.

• Coordinate and assist with account-level claims audits as needed.

• Analyze ongoing client-specific issues and proactively propose solutions to enhance service and satisfaction.

• Serve as a subject matter expert on the assigned client's benefits and member service experience.

• Perform additional duties as assigned.

⛳️ Requirements

• A Bachelor's degree in business administration, healthcare management, or a related discipline is preferred.

• Relevant work experience may be considered in lieu of a degree.

• A strong comprehension of claims management, benefits administration, and general insurance concepts and terminology is required.

• Previous experience in insurance, claims administration, account management, or customer service is mandatory.

• Exceptional oral and written communication skills, including the ability to present to groups such as HR teams and employees during enrollment meetings.

• Strong customer service orientation with the capacity to remain calm, tactful, and solution-focused when addressing sensitive employee concerns.

• Analytical and problem-solving abilities, with the skill to identify trends and suggest process improvements.

• Highly organized and self-motivated, capable of managing a full caseload independently in a remote work setting.

• Proficient in PC use, including familiarity with Microsoft Office products.

• Ability to handle conflicts and challenging issues professionally in a fast-paced environment.

• A reliable home internet connection is essential.

• A dedicated, private workspace is necessary for managing confidential health information.

• Must possess the ability to talk or hear and use hands or fingers to handle or feel objects, tools, or controls.

• Ability to occasionally stand, walk, sit, reach, and lift or move up to 25 pounds.

🏝️ Benefits

• Recognized as a certified “Great Place to Work” employer.

• Opportunity to work in a remote environment.

• Access to a dedicated, private workspace suitable for handling confidential health information.

• Reasonable accommodations may be provided to facilitate individuals with disabilities in performing their job functions.