Healthcare Management Administrators

As a Claims Specialist, you will ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims. You will also contribute to shaping a positive healthcare experience for members. | A high school diploma is required along with 3-5 years of claims processing experience, including 2 years with BCBS. Strong interpersonal skills and attention to detail are essential. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: www.accesshma.com How YOU will make a Difference: As a Claims Specialist, you’ll be at the heart of our mission to deliver exceptional service. Working alongside a dedicated team, you’ll ensure the accurate and timely processing of medical, dental, vision, and short-term disability claims that HMA administers for our members. Your role goes beyond handling claims, you’ll be a key player in shaping a positive healthcare experience for our members. Every claim you interact with helps someone navigate their healthcare journey with confidence, making your work both meaningful and impactful. What YOU will do: Carefully research discrepancies, process returned checks, issue refunds, and manage stop payments with precision. This ensures financial accuracy and builds trust with both clients and members. Manage high-importance claims and vendor billing with urgency and attention to detail. Review and reply to appeals, inquiries, and other communications related to claims. Work with third-party organizations to secure payments on outstanding balances. Process case management and utilization review negotiated claims Spot potential subrogation claims and escalate them appropriately. Actively contribute to team success by assisting colleagues when workloads peak, sharing knowledge, and fostering a collaborative environment. High school diploma required 3-5+ years of claims processing experience 2+ years of BCBS claims processing experience Strong interpersonal and communication skills Strong attention to detail, with high degree of accuracy and urgency Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving Previous success in a fast-paced environment Compensation: The base salary range for this position in the greater Seattle area is $28/hr - $32/hr for a level II and varies dependent on geography, skills, experience, education, and other job or market-related factors. While we are looking for level II, we may consider level III for highly qualified candidates. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: www.accesshma.com

Lead and manage claims operations staff and vendors to ensure accurate, timely, and compliant healthcare claims processing while driving operational improvements. | Bachelor’s degree or equivalent, 5+ years claims operations experience, 2+ years people management, expertise with claims platforms, coding knowledge, and vendor management skills. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: The Claims Operations Manager will oversee the end-to-end processing of healthcare claims. The manager is responsible for leading the HMA Claims Operations staff and their daily work requirements. Leveraging metrics and forecasts; they prioritize workload and resourcing to maximize operational production in partnership with vendor resources and liaisons. The manager will lead a team responsible for claims intake, pricing, adjudication, coordination of benefits and issue resolution while driving operational excellence What YOU will do: Direct supervisory responsibilities: Manages and coaches individual contributor’s performance and quality. Assess and manages claims inventory: Tracks and manages inventory trends and proactively adjusts resource levers as needed to maximize productivity Manage daily operations of claims processing, ensuring accuracy, timeliness, and compliance with healthcare policies and federal guidelines Create daily updates for management team flagging production rates, critical issues and areas of escalation in real time Monitor and resolve pricing discrepancies impacting claims adjudication and provider payments. Lead initiatives to improve pricing workflows, automation, and system performance. Vendor auditing &QA: Leads vendor audits and manages reporting to ensure vendor quality. Apply subject matter expertise to the business of claims processing and operations Manage to vendor agreements, proactively identify and flag issues, escalate appropriately Develop and maintain workflows and documentation specific to claims processing. Train and coach staff and vendors on claims processes as needed Motivate talent: Ability to motivate and lead team members and vendors in accordance with HMA values and objectives Talent planning: Proactively review and assess talent. Continually develop and/or recruit talent to meet objectives Knowledge, Experience and Attributes: Bachelor’s Degree or equivalent work experience Minimum 5 years’ of claims operations experience, self-funded health plan experience is a plus Minimum 2 years’ of people leading experience Experience with claims platforms such as HealthEdge, Mphasis, or Facets Knowledge of CPT, HCPCS, ICD-10 coding, and reimbursement methodologies. Strong understanding of provider contract terms, fee schedules, and pricing models (e.g., DRG, APC, RBRVS). Proven ability to manage and develop a team of highly skilled staff Proven ability to manage and interact with vendors to support execution of work within the SLA’s established Compensation: The base salary range for this position in the greater Seattle area is $100,000-$123,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit

Manage and optimize healthcare eligibility and enrollment systems, ensure compliance, lead troubleshooting, and provide technical leadership for a team. | Bachelor's degree in IT or related field, 5+ years technical operations experience in healthcare or insurance, expertise in EDI and enrollment platforms, strong leadership and problem-solving skills. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: The Technical Operations Manager will lead and manage the operational integrity of systems supporting healthcare eligibility and enrollment. This role ensures seamless data exchange between internal systems and external trading partners, supports compliance with regulatory requirements, and drives continuous improvement in technical workflows. What YOU will do: Oversee daily operations related to eligibility and enrollment data, focusing on 834 EDI file processing and reconciliation. Manage and optimize technical systems that support enrollment operations. Collaborate with IT and business teams to ensure accurate and timely transmission of 834 files to and from trading partners. Develop and maintain custom rule sets and real-time editing logic to support enrollment integrity. Lead troubleshooting efforts for file transmission errors, data mismatches, and system performance issues. Ensure compliance with HIPAA and other regulatory standards related to EDI transactions. Create and maintain dashboards and reporting tools to monitor file processing metrics and operational KPIs. Coordinate with vendors and service providers to resolve technical issues and enhance system capabilities. Provide technical leadership and mentorship to a team of analysts and support staff. Document processes, workflows, and system configurations related to eligibility operations. Facilitate collaboration across multidisciplinary teams using tools such as Teams, SharePoint, and advanced workflow integrations. Knowledge, Experience and Attributes: Bachelor’s degree in Information Technology, Computer Science, or a related field. 5+ years of experience in technical operations, preferably within healthcare or insurance. Strong understanding of ANSI X12 834 file format and EDI transaction sets (e.g., 820, 999). Experience with enrollment platforms such as HealthEdge, Mphasis or Facets. Familiarity with real-time editing systems and custom rule development. Edifecs experience preferred Background in healthcare member eligibility operations. Skilled at building relationships and moving projects forward with diverse audiences who have competing priorities Strong problem-solving and analytical skills Strong organization skills Strong leadership skills in keeping projects on schedule Compensation: The base salary range for this position in the greater Seattle area is $96,000-$118,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit: https://www.accesshma.com/

Manage and analyze payment integrity programs, identify issues and improvements, collaborate with internal teams and vendors, and ensure compliance with healthcare regulations. | 3-5+ years claims processing experience, 2+ years data entry, intermediate Excel skills, strong analytical and problem-solving abilities, and ability to manage complex workloads. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for three years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to add to our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: The Payment Integrity Analyst ensures assigned payment integrity programs are delivered efficiently and with high quality. Using claims expertise, program knowledge, and analytics capability, this person will provide the day-to-day management of assigned programs which may include, but aren’t limited to, our CMS Demand Case program and our Subrogation program. They will research case questions, resolve issues, identify process and program improvements, and ultimately contribute to the delivery of a strong portfolio of payment integrity programs. What YOU will do: • Provide strong analytical, problem-solving and quality assurance skills to support efficient, accurate and timely execution of assigned payment integrity programs • Combine healthcare knowledge and technical skills using programs including QicLink and Excel and reporting from vendor systems to gather, assess, and perform detailed evaluations of data to 1) Identify issues, recommend solutions, and manage situations to resolution, and 2) identify, evaluate and deliver new program improvements that increase cost containment results for HMA and its clients • Track, manage, and report on daily program inventory for short-term prioritization and long-term strategic planning • Evaluate existing business processes and policies and develop sustainable, measurable improvements • Produce clear written documentation to ensure consistent and accurate service provision, such as Procedural Work Instructions or Job Aids for core practices and business requirements for program changes • Collaborate effectively with internal teams including Appeals, Claims, Client Success, and Stop Loss to deliver an informed, coordinated experience for clients and members • Interact and communicate effectively with payment integrity program vendors and government agencies to meet program expectations • Maintain current in knowledge of claims processing, job-related systems, and associated government regulations, and pursue education and training relevant to Payment Analyst role • 3-5+ year of claims processing experience within the insurance industry • 2+ year data entry experience • Intermediate Excel skills with the ability to build effective spreadsheets and manipulate data • Able to manage a complex daily queue and prioritize workload effectively • Skilled in identifying root causes of issues through detailed investigation and inquiry • Able to analyze impacts of potential actions or decisions to determine the optimal choice Compensation: The base salary range for this position in the greater Seattle area is $78,000-$93,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: • Seventeen (IC) days paid time off (individual contributors) • Eleven paid holidays • Two paid personal and one paid volunteer day • Company-subsidized medical, dental, vision, and prescription insurance • Company-paid disability, life, and AD&D insurances • Voluntary insurances • HSA and FSA pre-tax programs • 401(k)-retirement plan with company match • Annual $500 wellness incentive and a $600 wellness reimbursement • Remote work and continuing education reimbursements • Discount program • Parental leave • Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit www.accesshma.com.

Lead and manage daily call center operations, implement new systems, mentor staff, monitor KPIs, collaborate across departments, and drive customer care strategy. | 10+ years customer service experience, 1-2 years managing 12+ staff, knowledge of call center principles, data-driven decision making, and preferably healthcare experience. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for four years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to diversify our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: We're looking for a dedicated Customer Care Manager who is enthusiastic about leading our call center team and championing new systems to elevate our customer service. If you have hands-on experience managing customer care advocates, training, reviewing data and analytics, enjoy finding creative ways to improve customer experiences, and love inspiring others to do their best work, we’d love to meet you. What YOU will do: Oversee the daily operations of the customer care call center, ensuring the accurate quoting of eligibility, benefits and claims status and ensure issues are resolved promptly and effectively. Lead by example and represent HMA’s ‘People First’ values. Implement and manage new systems and technologies to improve call center efficiency and customer satisfaction. Develop and monitor KPIs to measure the effectiveness of the customer care team and identify areas for improvement. Mentor and support customer care advocates to ensure they have the skills and knowledge needed to provide exceptional service. Collaborate with other departments to ensure a seamless customer experience and address any cross-functional issues. Manage resources to achieve departmental budget targets. Stay up-to-date with industry trends and best practices to continuously improve our customer care operations. Exhibit strategic agility and analysis to drive the customer care strategy forward. Manage complex challenges and drive critical decision-making processes. Maintain a future-oriented mindset to anticipate and prepare for industry changes. Lead through change, inspiring and building trust within the team. Knowledge, Experience, and Key Attributes needed for Success: Bachelor’s degree preferred 10+ years providing superior customer service preferably in a call center environment 1-2 years of proven experience managing a group of 12+ diverse customer care advocates including performance management. In-depth knowledge of customer service principles and practices is required Experienced managing and monitoring customer call que Knowledge of policies involving managing non-exempt individual contributors Proven ability to collaborate with diverse business groups across the organization Uses data and analytics to make decisions and recommendations for refinement Highly organized and detail-orientated Previous experience working in a medical or healthcare field is preferred The base salary for this position in the greater Seattle area is $104,000-$115,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit www.accesshma.com.

This role is responsible for the successful implementation and programming of clients' benefit plans, ensuring benefits are correctly programmed and product services are readily available for members. The position involves reviewing prior SPDs, creating plan summaries, and assisting with complex customer service issues. | A high school diploma or equivalent experience is required, along with 3-5 years of relevant experience. Strong knowledge of QicLink and analytical skills are crucial for translating client intent into programming of their benefits. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for four years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to diversify our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: This role is responsible for the successful implementation and programming clients benefit plans, as setting up buy up products for our clients as well as managing third party vendor files. The importance of this role is to ensure benefits are correctly programmed and product services are readily available for members. What YOU will do: Review prior SPD’s and make recommendations for new group implementations, such as system capabilities and regulatory requirements, and present to new clients as needed. Ask clarifying questions about plan details that could be missing. Create and update plan summaries and program the claims system for simple and medium complexity client renewals and implementation of off-cycle benefit changes. With the assistance of the Plan Building Specialist II or III, assist with programming updates for clients with complex renewals. Assist with complex and escalated customer service issues to ensure resolution. maintaining the vendor file maintenance for buy-up products. This includes incoming/outgoing files, setting up SFRP and retroactive programming of the balance of our Book of Business, to facilitate non-standard benefits for select groups. Work with vendor to ensure accurate EOB design and setup as needed. Review and respond to applicable TechOps Support tickets and MDI claims queries as needed. Assist Plan Building Specialist III with programming new group implementations as needed. Assist with complex and escalated customer service issues to ensure resolution. Retroactive programming of the balance of our Book of Business, to facilitate non-standard benefits for select groups. Assist in training of Plan Building Specialist I team members. Review and respond to applicable TechOps Support tickets and MDI claims queries as needed. Conduct peer-to-peer audit for Plan Building team programming. Knowledge, Experience, and Key Attributes needed for Success: High school diploma or equivalent experience required 3-5 years of recent relevant experience Strong QicLink knowledge is beneficial for the programming of benefits in QicLink. Strong analytical skills are crucial for translating client intent into programming of their benefits in QicLink. Comprehensive understanding of benefits that we administer and different plan types. Solid understanding of regulations that impact benefit design, including but not limited to, the Affordable Care Act, Mental Health Parity and IRS rules related to administration of high deductible health plans. Clear and effective verbal and written communication skills. Strong interpersonal skills and ability to work with team members at all levels. The base salary for this position in the greater Seattle area is $108,000-$120,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit www.accesshma.com.

Lead and manage the daily operations of a customer care call center, implement systems to improve efficiency, mentor staff, and collaborate across departments to enhance customer experience. | 10+ years customer service experience, 1-2 years managing 12+ customer care advocates, knowledge of call center operations, data-driven decision making, and preferably healthcare experience. | HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for four years, HMA has been chosen as a ‘Washington’s Best Workplaces’ by our Staff and PSBJ™. Our vision, ‘Proving What’s Possible in Healthcare™,’ and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to diversify our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: https://www.accesshma.com/ How YOU will make a Difference: We're looking for a dedicated Customer Care Manager who is enthusiastic about leading our call center team and championing new systems to elevate our customer service. If you have hands-on experience managing customer care advocates, training, reviewing data and analytics, enjoy finding creative ways to improve customer experiences, and love inspiring others to do their best work, we’d love to meet you. What YOU will do: • Oversee the daily operations of the customer care call center, ensuring the accurate quoting of eligibility, benefits and claims status and ensure issues are resolved promptly and effectively. • Lead by example and represent HMA’s ‘People First’ values. • Implement and manage new systems and technologies to improve call center efficiency and customer satisfaction. • Develop and monitor KPIs to measure the effectiveness of the customer care team and identify areas for improvement. • Mentor and support customer care advocates to ensure they have the skills and knowledge needed to provide exceptional service. • Collaborate with other departments to ensure a seamless customer experience and address any cross-functional issues. • Manage resources to achieve departmental budget targets. • Stay up-to-date with industry trends and best practices to continuously improve our customer care operations. • Exhibit strategic agility and analysis to drive the customer care strategy forward. • Manage complex challenges and drive critical decision-making processes. • Maintain a future-oriented mindset to anticipate and prepare for industry changes. • Lead through change, inspiring and building trust within the team. Knowledge, Experience, and Key Attributes needed for Success: • Bachelor’s degree preferred • 10+ years providing superior customer service preferably in a call center environment • 1-2 years of proven experience managing a group of 12+ diverse customer care advocates including performance management. • In-depth knowledge of customer service principles and practices is required • Experienced managing and monitoring customer call que • Knowledge of policies involving managing non-exempt individual contributors • Proven ability to collaborate with diverse business groups across the organization • Uses data and analytics to make decisions and recommendations for refinement • Highly organized and detail-orientated • Previous experience working in a medical or healthcare field is preferred The base salary for this position in the greater Seattle area is $104,000-$115,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: • Seventeen (IC) days paid time off (individual contributors) • Eleven paid holidays • Two paid personal and one paid volunteer day • Company-subsidized medical, dental, vision, and prescription insurance • Company-paid disability, life, and AD&D insurances • Voluntary insurances • HSA and FSA pre-tax programs • 401(k)-retirement plan with company match • Annual $500 wellness incentive and a $600 wellness reimbursement • Remote work and continuing education reimbursements • Discount program • Parental leave • Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA’s standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit www.accesshma.com.