Job DescriptionMaintain and helps grow market share by providing excellent customer service and account management to clients. Manages assigned accounts by analyzing, directing and coordinating the service needs of these clients, including those related to claim handling loss data, and cost containment, and assists with billing and collections. Negotiates and facilities the successful renewal of account service contracts, assuring team collaboration in accordance with customer needs and expectations. Increase market share by selling additional service to existing clients. Provides account management to large programs with visibility and growth retention.
Responsibilities- Serve as the primary client relationship manager for medical management programs within a TPA environment.
- Coordinate implementation, service delivery, and ongoing account management for medical management solutions, including case management, utilization review, and related clinical services.
- Partner with clients, claims teams, clinical staff, and operational leaders to ensure program performance and customer satisfaction.
- Monitor service metrics, trends, and outcomes, providing regular reporting and strategic recommendations.
- Identify opportunities to improve medical cost containment, return-to-work outcomes, and overall program effectiveness.
- Support renewals, retention efforts, and growth initiatives within assigned accounts.
- Resolve client issues and escalate concerns as needed to ensure timely resolution.
- Maintain a strong understanding of workers' compensation, managed care, and medical management industry practices.
- This role differs from a traditional Account Executive position by requiring deeper expertise in medical management programs, clinical service coordination, and healthcare cost-containment strategies.
Qualifications- Bachelor's degree or an equivalent combination of education and experience. A medical degree is not required; however, a strong understanding of medical terminology, treatment progression, and claim lifecycles is essential.
- Six (6) or more years of experience in medical case management, healthcare account management, workers' compensation, disability management, or related healthcare and claims environments.
- Proven ability to manage and grow client accounts, coordinate medical service delivery, interpret and discuss medical information, and ensure positive customer outcomes.
- Ability to drive service agreements to signature.
- Understanding of industry pricing methodologies and monthly invoicing oversight.
- Understanding of Crawford role in service delivery.
- Report building and analytics via our iQ Portal.
- "Can do/winning" attitude, not easily discouraged by internal or external forces.
- Understands concepts of claim and medical processing - intake to closure.
- Strong medical claim product and service knowledge.
- Must complete continuing education requirements as outlined by Crawford Educational Services.
- The Pay Range/Salary represents the anticipated low and high pay that may be offered for this position. To determine the actual offer, Crawford considers a wide range of factors including the candidate's previous experience and education, market rates, minimum pay requirements for the applicable jurisdiction, business segment, supply/demand, and scheduled hours.
- Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
- We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits* offered include:
- Medical, Dental and Vision Plans
- Prescription Drugs
- HSA, HRA, and FSA Accounts
- Paid Holidays, Vacation and Sick Leave
- 401(k) Retirement Plan
- Tuition Assistance
- Paid Parental Leave
- Supplemental Health Benefits
Other Benefits currently available at no cost include: - Enhanced Mental Health Support
- Virtual Physical Therapy
- Caregiving Services
- Life Assistance Program
*The above information highlights some of the benefits currently available to eligible full-time employees.
- Training programs that promote continuous learning and career progression while enhancing job performance.
- Sustainability programs that give back to the communities in which we live and work.
- A culture of respect, collaboration, entrepreneurial spirit and inclusion.
