Posted: 06/23/2022

    In this position with our Insurance Division, you would be responsible for overseeing the administration of TPA (HRA/FSA/POP) and COBRA for agency clients.  Additional responsibility to analyzing and managing systems and processes within the agency.  Works with insurance management team to ensure quality, efficiency, and accuracy of policies, procedures, and service to meet Company goals and strategic objectives.

    Responsibilities Include:

    • Administer TPA Plan (HRA/FSA/POP) including client set-up, renewals, and debit card maintenance.
    • Analyze, resolve, and process HIPAA protected reimbursement requests and payments for HRA/FSA/DCAP accounts.
    • Advise Employer Groups and plan participants of eligible versus ineligible claims.
    • Generate management and Employer Group reports including enrollments, claims, and payments; approve PHI Authorization and Group Health Plan authorization forms.
    • Monitor account balances and obtain finding for reimbursement accounts.  Contact plan participants to respond to inquiries or for notification of reimbursement investigation results and/or claims adjustments.
    • Administer COBRA for clients including:  initial notice generation, notifications, acceptance processing and payment coupon distribution, payment collection, premium payments to Employer Groups, and monitoring participant payment and enrollment status.
    • Analyze data systems and processes to ensure efficiency and effectiveness; oversee system maintenance and work with IT on issues as needed.
    • Assist end-users with troubleshooting, provide training on systems administration, and stay current on systems enhancements/upgrades/usage; assist with administration of new releases.
    • Work with management team and assist operations manager with day-to-day operations, organize monthly meetings and staff communications, perform account management duties beyond TPA as assigned, and research DOL/DFS/IRS/ACA regulations and help set up processes to ensure compliance.
    • Bachelor’s Degree in related field or equivalent experience required
    • 6+ years of experience in insurance industry or related field required
    • Valid insurance licenses from New York State Department of Insurance required
    Skills/Knowledge Requirements:
    • Strong problem-solving skills; ability to assess needs, research options, and recommend solutions
    • Working knowledge of agency management systems; specific knowledge of AMS 360 preferred
    • Excellent communication skills, both written and verbal; comfortable communicating with clients, co-workers, and management
    • Ability to work independently and as cooperative team member
    • Proven ability to adapt and prioritize multiple tasks while meeting strict deadlines; attention to detail and efficiency a must
    • Proficient with Microsoft Office Suite:  Word, Excel, and Outlook