Account Representative I

Posted 3 Hours Ago
Be an Early Applicant
Omaha, NE, USA
In-Office
57K-97K Annually
Entry level
Healthtech • Insurance
The Role
Manage a portfolio of small group health plan accounts and support broker relationships. Provide guidance on products, pricing, regulations, enrollment, billing, claims, eligibility, and benefits. Research and resolve escalated service issues, maintain account documentation, and collaborate with internal specialists to support client satisfaction and retention. The role requires strong communication, negotiation, independent work, and knowledge of fully insured and self-funded health plans.
Summary Generated by Built In

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.   

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.  

Work with external broker distribution channel supporting new and renewing small group Commercial business, providing guidance on regulatory requirements, processes, products and value adds available. Provide service on enrollment, billing and claims issues. Performs other duties as assigned.

The Account Representative is a small group business specialist with expertise in Medica’s products, pricing, sales guidelines, and operational processes.  The incumbent partners with the Agency Relationship Managers to provide consultation and education to Medica’s broker distribution channel on all aspects of Medica’s small group business. The incumbent has on-going interaction with the broker channel to quote, install, retain and service our small group fully and self-insured business.

The Account Representative has significant interaction, collaboration and negotiation with functional content specialists across all operations to address client questions and demands. This position is critical for client satisfaction and the ability to retain the business relationship with Medica.

Key Accountabilities 

  •  Manage an assigned portfolio of small group accounts.
  • Prioritize workload, monitor account activity, and maintain accurate account documentation. 
  • Build and maintain strong relationships to support retention and client satisfaction.
  • Research, coordinate, and resolve escalated service issues.
  • Manage inquiries related to eligibility, billing, enrollment, claims, and benefits.

Qualifications:

  • Bachelor's degree or equivalent combination of education and experience required 
  • Relevant experience could include, Customer Service, Vendor Management, Account Management, Group Health, Benefits Administration, Human Resources, etc.
  • Demonstrated proficiency in working with both fully insured and self-funded health plans preferred
  • Experience working with brokers preferred
  • CRM experience preferred ex. Salesforce, Brokerlink, etc.

Specific types of experience or skills required: 

  • Ability to gain thorough knowledge of federal/state regulations and Medica’s requirements related to small group validation as well as the requirements for submission
  • Strong interpersonal, relational skills in the management of client service
  • Excellent written and verbal communication skills
  • Ability to negotiate successful outcomes with client
  • Ability to work independently 
  • Self-driven, motivated and results oriented 

    This position is an Office role, which requires an employee to work onsite at our Omaha, NE office, on average, 3 days per week.  

    The full salary grade for this position is $56,600 - $97,000. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $56,600 - $84,840. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data.  In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.  

    The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.  

    Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States. 

    We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic. 

    Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
    This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

    Skills Required

    • Bachelor's degree or equivalent combination of education and experience
    • Relevant experience in customer service, vendor management, account management, group health, benefits administration, human resources, or a related field
    • Knowledge of federal and state regulations and small group validation and submission requirements
    • Strong interpersonal and relationship management skills
    • Excellent written and verbal communication skills
    • Ability to negotiate successful outcomes with clients
    • Ability to work independently
    • Self-driven, motivated, and results-oriented
    • Experience with fully insured and self-funded health plans
    • Experience working with brokers
    • CRM experience, such as Salesforce or Brokerlink
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    The Company
    HQ: Minnetonka, MN
    2,973 Employees
    Year Founded: 1975

    What We Do

    Medica is a non-profit health plan that serves communities in Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin — the heart of America. As a company, we empower communities by listening to their voices, learning about community needs, and devoting time and resources to help. Medica partners with the communities it serves in many ways, including the Medica Foundation, a nonprofit, charitable grant-making foundation. The Medica Foundation, which provides more than $1 million in grants annually, generally seeks to fund community-based programs and initiatives that can provide sustainable, measurable improvements in the availability, access and quality of health care. Mission To be the trusted health plan of choice for customers, members, partners and our employees. Vision To be trusted in the community for our unwavering commitment to high quality, affordable health care. Values Customer Focus Excellence Stewardship Integrity Diversity

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