About the Role

The Account Supervisor is responsible for building and maintaining positive working relationships with our new and existing clients to ensure customer satisfaction and promote customer retention. This position requires the candidate to be detail oriented, professional and well-spoken to ensure all written and verbal responses are concise and accurate.   

Primary Responsibilities

•    Establish effective working relationships with our customers.

•    Act as the primary point of contact between MagnaCare and our clients.

•    Provide accurate and timely responses to all client inquiries including written correspondence and/or verbal requests.

•    Effectively communicate with clients, providers and members verbally and in writing.

•    Capture and document all client interactions into our internal tracking system.

•    Advanced claim processing including professional, facility and ancillary claims.

•    Investigate claim payment/pricing inquiries upon client’s request.

•    Apply medical policy, contractual provisions and operational procedures to ensure accurate adjudication and/or                  adjustment.

•    Generate and analyze reports to identify root cause analysis of client payment issues.

•    Ability to identify negotiation solutions and resolve conflicts in a manner that will ensure client and satisfaction.

•    Perform as a liaison between internal contacts and our clients.

•    Manage eligibility and COB issues.

•    Prepare detailed cases for 2nd Level Appeals.

Essential Qualifications

•    Bachelor’s Degree preferred.

•    1+ years claims adjudication experience.

•    Advanced claims processing including professional, facility and ancillary claims.

•    Comprehensive knowledge of health care customer service.

•    Excellent communication skills, both oral and written.

•    Strong attention to detail and ability to self-check work.

•    Excellent time management skills.

•    Task oriented, excellent organizational skills, ability to prioritize work load.

•    Enthusiastic attitude, cooperative team player, adaptable to new or changing circumstances.

•    Excellent problem-solving skills.

•    Ability to prioritize, multitask and work independently on tasks.

•    High level computer literacy and technical competence.

•    Ability to collaborate with multiple parties, both internal and external to solve problems.

•    Establish and maintain positive and effective work relationships with clients, coworkers, members, providers and             customers.

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.

Come be a part of the Brightest Ideas in Healthcare™.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement  

At BHPS, we encourage all team members to bring your authentic selves to work with all of your unique abilities.   We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace.  We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer

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