Scope of Responsibilities: Works under direct supervision and follows standard procedures to accomplish assigned tasks related to the Implementation and Benefit Review Team.

Job Summary: Provides support to the Implementation Manager for all aspects of customer service, account management, quality assurance, and other administrative projects. The position will act as a lead role within Benefit Review and be a liaison to management and other organization leaders, while still performing the daily functions of a Benefit Review Specialist. These functions include, but are not limited to, assisting with the day-to-day operations of Account and Client Service Resources of ProAct and coordinating and implementing the setup/support of existing ProAct clients.

• Act as the Benefit Review Team leader; facilitate regular meetings with all Benefit Review Specialists.
• Process and implement benefit changes and/or updates for existing ProAct clients in all appropriate systems.
• Oversee and perform testing for all new ProAct clients to measure benefit accuracy.
• Assist the Implementation Manager in coordinating the team’s audit strategy.
• Perform quality assurance audits on a regular basis to measure client satisfaction.
• Assist Account Resources with impact analysis review.
• Maintain client information integrity within all appropriate systems.
• Assist Customer Service Representatives in the resolution of customer service issues, requiring additional support, to ensure complete client satisfaction.
• Assist Account Resources in the resolution of customer service issues, requiring additional support to ensure complete client satisfaction.
• Coordinate, maintain, and manage the distribution of member mailings.
• Collect and maintain various team metrics, providing regular reporting to the Implementation Manager and other leaders, as necessary.
• Assist in facilitating and performing training sessions for both new and existing employees.
• Provide support to the Implementation Manager and/or the Account and Client Resources, as needed, when communicating with external business partners.
• Responsible for completing all mandatory and regulatory training programs.

• Perform other duties as assigned.

Education:

• Required: Minimum High School Diploma or GED
• Preferred: AS Degree or Higher in Business Administration, Marketing or related field

Experience:

• Required: Minimum 1year experience with the RxSense adjudication and reporting platforms
• Required: 2 years experience in Customer Service
• Preferred: 2 years experience with Health Care, Insurance, or related field

Compensation:

$22.00 - 24.00 per hour.

The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience, and education.  

KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state, and federal regulations as it pertains to minimum wage requirements.