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Account Manager - Stop Loss
Account Manager - Stop LossAfore Insurance Services • San Antonio, TX, US
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Account Manager - Stop Loss

Account Manager - Stop Loss

Afore Insurance Services • San Antonio, TX, US
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We are seeking a highly skilled and client-focused Account Manager to join our dynamic team at SA Benefit Services, a Division of Afore Insurance Services, LLC. In this role, you will be responsible for managing a portfolio of key accounts, serving as the primary liaison between our agency, brokers, third-party administrators (TPAs), and carriers. Your expertise in stop loss insurance, self-funded healthcare plans, and underwriting processes will ensure a high level of service delivery, client retention, and operational excellence. Candidates for this position must have reliable internet service and can travel to team meetings in the San Antonio, Texas. We are looking for candidates to work remote in the San Antonio, Texas or surrounding area.

Benefits

Annual Base Salary Based on Experience

Work from Home

Paid Time Off (PTO)

Health Insurance

Disability Insurance

Life Insurance

Dental Insurance

Vision Insurance

Hands on Training

Tuition Reimbursement

Mon-Fri Schedule

Career Growth Opportunities

Retirement Plan

Responsibilities

  • Present stop loss presentations to producers and clients as it relates to RFP process, implementation, open enrollment and policy administration.
  • Responsible for being the subject matter expert on all accounts assigned. This individual will drive questions and assist the client, broker, TPA and carriers with challenges throughout the life cycle of the policy.
  • Build and release RFPs for current block of business assigned and request additional information as needed for the marketing of renewals.
  • Receive new RFPs from clients or vendors and request additional information within 24 hours of receipt. A clean RFP must be released to the carriers within 24 hours.
  • Responsible for Initial and Best and Final stages of the RFP processes to include, but not limited to :

o Initial RFP Stage Review RFP and reports received, request info as needed.

  • Release RFPs to stop loss carriers, answer questions, receive quotes, and review.
  • Spreadsheet quotes received and consult with Chief Executive Officer
  • Negotiate with stop loss carriers
  • Answer RFP questionnaires and complete forms, if necessary for the RFP.
  • o Best and Final RFP Stage Analyze final reports

  • Clear contingencies in quotes
  • Request info as needed
  • Release final reports to carriers, answer questions, receive quotes, and review.
  • Compare Stop Loss Policy exclusions / limitations to Plan Document
  • Spreadsheet quotes received and consult with Chief Executive Officer
  • Negotiate with stop loss carriers
  • Responsible for implementing new and renewal accounts sold.
  • Obtain all required documentation needed to issue the final policy

    o Receive stop loss application and policy, review, and audit for accuracy

    Monthly Reporting and Claims Filing

    o Populate SA Benefit Services monthly reporting package interfacing medical and prescription reporting from vendors on a monthly basis for assigned block of business.

    o Request eligibility and work status from the client

    o File stop loss claims with the stop loss carrier

    o Answer all claim questions that may arise in a timely manner

    o Track reimbursement status

    o Release monthly reporting packages to the client, broker, TPA on a monthly basis

    Requirement

  • 3-5 years of experience in account management within the stop loss, self-funded, or employee benefits industry.
  • Strong knowledge of stop loss products, underwriting principles, and claims processes.
  • Proven ability to manage multiple high-touch accounts with competing priorities.
  • Exceptional interpersonal, communication, and negotiation skills.
  • Highly organized with strong analytical and problem-solving abilities.
  • Proficiency in Microsoft Office (Excel, Word, PowerPoint); experience with CRM systems a plus. Bachelors degree in Business, Healthcare Administration, or related field preferred.
  • Active General Lines Health and Life Insurance License
  • Willingness to travel within San Antonio, Texas for frequent team meetings.
  • Strong attention to detail, research, organizational and time management skills; ability to prioritize projects; self-starter. Ability to think strategically, creatively and independently.
  • Strong writing, mathematical, inter-personal and communication skills in person, on the phone, video meetings and through email.
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