Group Customer Care Manager

Job Description

Job Description

Job Summary:

The Manager of Group Customer Care oversees all aspects of group voluntary benefits insurance administration: new group onboarding, electronic data interchange (EDI), account management, claims customer service, billing, payment processing, coverage termination, and other administrative processes. This role ensures efficient administration of various group voluntary insurance products, leading a team dedicated to delivering exceptional service to internal stakeholders and external customers.

This role is responsible for the day-to-day operations within the group division, supporting customers through all phases of operations from implementation and file transfer setup to billing, payment processing, and ongoing account management. The Manager’s key objective is to ensure the team provides comprehensive assistance and exceptional customer service that aligns with the company’s service standards and objectives.

Beyond operational oversight, the Manager of Group Customer Care must uphold Atlantic American Corporation’s Mission, Vision, and Values by fostering internal partnerships and demonstrating customer service excellence. Strong communication skills, both verbal and written, are essential, along with expertise in technology tools, analytics, and problem-solving. A thorough understanding of group health and life insurance products, compliance requirements, and industry principles is critical to driving efficiency and service excellence.

Key Responsibilities:

• Operational Oversight: Manage day-to-day operations of group policy administration, billing, customer service, account management and claims inquiries to ensure adherence to company policies, regulatory requirements, and service level agreements. Ensure timely and successful service delivery to internal and external customers.
• Team Leadership: Lead and mentor team members. Foster a culture of collaboration, continuous improvement, and customer-centricity. Develop long-lasting, trusted-advisor relationships with plan administrators and key customer stakeholders.
• Training and Development: Develop training programs and resources for new hires as well as ongoing skills enhancement for current team members. Ensure the team is equipped with necessary technical knowledge and customer service skills to exceed customer expectations.
• Process Improvement: Identify opportunities to streamline operations, enhance efficiency, and improve quality through process redesign, automation, and implementation of best practices.
• Financial Management: Oversee financial transactions related to premiums, claims payments, and reimbursements. Ensure accuracy, compliance, and efficient funds management.
• Customer and Agent Support: Collaborate closely with customer service teams to resolve escalated issues, provide guidance on complex cases, and ensure timely resolution of customer and broker inquiries. Deliver strong and strategic relationship management, communication, and reporting. Identify and remediate issues.
• Policy Support: Work closely with underwriting teams to review and assess policy applications, endorsements, and renewals. Ensure accuracy and compliance with underwriting guidelines.
• Risk Management: Monitor and assess operational risks, develop mitigation strategies, and implement controls to safeguard company assets and maintain regulatory compliance.

Qualifications:

• Minimum two to four years of experience in Group Insurance operations
• Three or more years of experience leading insurance operations with a focus on group life and health products
• Bachelor’s degree in Business Administration, Insurance, Finance, or related field (Master’s degree preferred)
• Strong understanding of the life and health insurance industry, insurance policies, claims processing, underwriting, risk management principles, privacy, and regulatory compliance
• Experience in leading cross-functional teams and managing operations to drive efficiency and exceptional customer service in a complex operational environment
• Demonstrated expertise training, developing, coaching, and mentoring a diverse team
• Experience in process improvement and workflow optimization using process-improvement methodologies such as Six Sigma or Lean is preferred

Skills:

• Analytical Skills: Strong analytical skills with the ability to interpret data, identify trends, make data-driven decisions, analyze performance metrics, and implement strategies for improvement
• Attention to Detail: Exceptional attention to detail to ensure accuracy in processing and documentation
• Communication: Excellent verbal and written communication skills, ability to interact effectively with internal and external stakeholders, strong negotiation and conflict resolution skills
• Process improvement: Demonstrated experience improving processes and driving efficiency
• Time Management: Ability to handle multiple tasks efficiently, prioritize work, and manage time, people, and projects efficiently in a high-volume environment
• Leadership and Organizational Skills: Proven ability to effectively influence others and resolve client and technical issues
• Technical Skills: Proficiency with Microsoft Office Suite particularly Excel (VLOOKUP & Pivot Tables), Word, PowerPoint, Outlook, and Teams
• Integrity: Strong commitment to ethical standards in healthcare billing and fraud prevention
• Adaptability: Flexibility to adapt to changing industry trends, company policies, and stakeholder needs
• Collaboration: Ability to work collaboratively with internal and external stakeholders
• Customer Service: Superior customer service skills and commitment to excellence

Work Environment / Physical Requirements:

The work environment is a standard office setting with typical office equipment. This role involves professional collaboration with colleagues and clients. Responsibilities may involve extended periods of sitting, occasional walking between departments or meeting rooms, and periodic standing, reaching, stooping, and lifting office items weighing up to 25 pounds.