RBP Program Specialist
Atlanta - Asbury Automotive, Georgia, United States of America
Management
2601BW
RBP Program Specialist
Atlanta - Asbury Automotive, Georgia, United States of America
Management
2601BW
Working at Lockton
At Lockton, we’re passionate about helping our people achieve their ultimate potential. Our people are curious, action-oriented and always striving to make ourselves and those around us better. We’re active listeners working to ensure understanding and problem solvers developing innovative solutions. If you can see yourself delivering excellent service to clients, giving back to our communities and being a part of our caring culture, you belong here.
About the Position
The Reference Based Pricing (RBP) Program Specialist operates onsite or remotely, embedded with an assigned client to support the implementation and ongoing administration of the client's reference based pricing health plan program. The Specialist serves as subject expert with responsibilities to include partnering with the client's Human Resources and benefits teams, providing direct employee support and education on the RBP model, and completing various client-specified duties related to the program.
Your Responsibilities
ESSENTIAL FUNCTIONS
Program Implementation and Administration: Supports the rollout and ongoing administration of the client's reference-based pricing program; applies detailed understanding and in-depth working knowledge of the RBP plan design, pricing methodology, and vendor/TPA workflows; and ensures the model is applied consistently and in accordance with plan documents
Employee Service and Support: Serves as the embedded resource guiding employees to understand and navigate the RBP model; responds to member inquiries in a timely manner; educates employees on how reference based pricing works including provider selection, and cost expectations; investigates and resolves member concerns, including balance billing situations; acts as a liaison between the client's HR department, employees, Lockton, and the RBP vendor/TPA
Operational Service and Support: Completes various processes and program-related duties, in collaboration with the client; duties include (but are not limited to) eligibility and enrollment processing, tracking and auditing of claims and repricing data, balance billing resolution support, reporting on program metrics and savings, and coordinating with vendors on escalations
Operations: Operates on a fluctuating schedule during open enrollment periods and/or special projects to meet the needs of the client, potentially including evenings or weekends
Qualifications
REQUIRED EDUCATION AND EXPERIENCE
- High School Diploma/GED or professional direct experience equivalency
- Minimum of three (3) years of subject matter expert experience working directly with a reference based pricing (RBP) health plan model
- Proven knowledge of medical billing, claims processing, and healthcare pricing/repricing concepts
- Intermediate proficiency in Microsoft Excel
- Demonstrated polished, articulate verbal and interpersonal communication skills with the ability to explain complex concepts to employees
- Professional experience demonstrating superior customer service skills while multi-tasking and working under strict deadlines
- Proven experience following a step-by-step process while using deductive reasoning to produce positive outcomes
PREFERRED EDUCATION AND EXPERIENCE
- Five (5) or more years of professional experience implementing, administering, and/or supporting reference based pricing programs
- Experience with balance billing resolution, provider negotiation, and member advocacy
- Working knowledge of self-funded health plans, TPA operations, and ERISA
- Associate's or Bachelor's Degree or equivalent combination of education, training, or experience
Equal Opportunity Statement
Lockton Companies is proud to provide everyone an equal opportunity to grow and advance. We are committed to an inclusive culture and environment where our people, clients and communities are treated with respect and dignity.
At Lockton, supporting diversity, equity and inclusion is ingrained in our values, and we believe that we are at our best when we fully embrace everyone. We strive to cultivate a caring culture that learns from, celebrates and thrives because of our breadth of differences. As such, we recognize that recruiting, developing and retaining people with diverse backgrounds and experiences is vital and enabling our people to thrive personally and professionally is critical to our long-term success.
About Lockton
Lockton is the largest privately held independent insurance brokerage in the world. Since 1966, our independence has allowed us to serve our clients, take care of our people and give back to our communities. As such, our 13,100+ Associates doing business in over 155 countries are empowered to do what’s right every day.
At Lockton, we believe in the power of all people. You belong at Lockton.
How We Will Support You
At Lockton, we empower you to be true to yourself in all that you do. Your success is our success, and we provide opportunities to help you grow and create a rewarding career path, however you envision it.
We are ready to meet you where you are today, and as your needs change over time. In addition to industry-leading health insurance, we offer additional options to support your overall health and wellbeing.
No Agencies Please
Any Employment Agency, person or entity that submits an unsolicited resume to this site does so with the understanding that the applicant's resume will become the property of Lockton Companies, Inc. Lockton Companies will have the right to hire that applicant at its discretion and without any fee owed to the submitting Employment Agency, person or entity. Employment Agencies, who have fee Agreements with Lockton Companies must submit applicants to the designated Lockton Companies Employment Coordinator to be eligible for placement fees.
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