Client Relations Specialist

CGS Health
New York
May 10, 2018
Jun 07, 2018
Employer Type
Direct Employer
Employment Type
Full Time
Job Board
Job Description

Client Relations Specialist

CGS Health provides management and administration of employers' self-insured health benefit programs. The Client Relations Specialist serves as the primary point of contact for our clients and is responsible for maintaining the highest level of customer satisfaction. Each Client Relations Specialist will have primary responsibility for 5-8 clients. Hours are generally 9:00AM to 5:00PM with some flexibility required. Infrequent travel as necessary (

Specific responsibilities include:

Serve as the primary day to day point of contact for all client issues/inquiries including

  • employee eligibility
  • health plan benefit details
  • claims details and claim payment status
  • invoicing and claims funding
  • Regular, proactive communication with clients
  • Gathering data and preparing client and prospect updates and renewal presentations
  • Generating, analyzing, and delivering monthly client reporting
  • Coordinating health coverage enrollment, changes, and terminations for our clients
  • Processing COBRA communication and enrollment for terminated employees
  • Speaking with medical service providers on behalf of the client and enrolled employees
  • Onboarding new clients - entering data in our internal systems and vendors' systems
  • Orienting new clients and explaining operational procedures
  • Communicating with Insurance carriers, underwriters and networks on behalf of CGS Health and our clients

Qualifications and Experience

  • Knowledge of health insurance and medical benefits plans is required
  • Knowledge of self-funded medical plans and stop-loss insurance is strongly preferred
  • 1 or more years of experience in customer service or account management in health-care, insurance, employee benefits, or human resources industry
  • Excellent customer service skills
  • Excellent task management and time management skills
  • Advanced problem resolution skills
  • A self-starter with the ability to work with minimal supervision
  • Excellent word processing and spreadsheet skills
  • Comfortable working under pressure in a fast-paced environment
  • Proficiency in English and excellent verbal and written communication skills are required
  • Proficiency in Spanish, Korean or another foreign language is a plus
Company Description Since 1974, Cook Group has been a leading provider of third party administration (TPA) services and medical stop-loss insurance products to the private-sector employer health benefits marketplace. Currently we administer more than 75,000 self-insured covered lives across medical, pharmacy, dental and vision benefits. The Cook Group team has the third party administrative capabilities and medical stop loss experience to tailor a self-insured benefits plan for any group of 50 lives or more nationwide.

Our expertise comes backed by thoroughly vetted self-insurance partners, including, but not limited to industry-leading health networks, claims management and adjudication, ERISA plan document creation, and medical stop-loss underwriters and carriers. Medical stop-loss insurance is an important component of a comprehensive health plan. We work closely with plan sponsors to keep costs under control and all interests aligned.