TPA Specialist

Acrisure•Grove City, PA

6d•Onsite

About The Position

Acrisure is a global fintech leader that empowers millions of businesses and individuals with customized solutions across insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services, and more. The company has grown significantly in revenue and global presence. We are seeking a TPA Specialist to join our Employee Benefits Third-Party Administration (TPA) & Technology team. This role is crucial for daily TPA operations, focusing on client servicing, plan administration, and delivering key results that enhance client satisfaction and retention. The TPA Specialist will support Consumer Driven Health Plans (FSA, HRA, HSA), COBRA administration, benefits technology platforms, compliance services, claims processing, and client support. This position is vital for the expansion of TPA operations, including onboarding new clients and managing administrative services previously handled by external vendors.

Requirements

Strong communication, organization, and customer service skills.
Attention to detail with the ability to manage multiple priorities.
Proficiency in Microsoft Office (Word, Excel) and general computer skills.
Analytical mindset with the ability to work independently and solve problems.
Ability to handle confidential information with professionalism and discretion.
Willingness to learn benefits administration, insurance terminology, compliance requirements, and related technology platforms.
Commitment to continuous learning and professional growth.

Nice To Haves

Associate's degree or Bachelor's degree in Business, Finance, Human Resources, Healthcare Administration, Insurance, or a related field preferred.
Equivalent combination of education, training, and relevant work experience will be considered.
Previous experience in employee benefits administration, insurance, banking, customer service, claims processing, healthcare administration, or a related field is highly preferred.
Experience working with benefits administration platforms, COBRA administration, or consumer-driven health plans is a plus.

Responsibilities

Manage daily monetary transactions for claims, contributions, and revenue.
Process Positive Pay and ACH files for FSA, HRA, and HSA accounts.
Set up and maintain new and existing consumer-driven health plan clients.
Generate monthly invoices for administrative services clients.
Maintain and support the 1Cloud Consumer Accounts platform.
Provide exceptional customer service to individual and group clients.
Develop a working knowledge of consumer-driven health plans and related services.
Maintain confidentiality and comply with all HIPAA and PHI regulations.
Understand the structure and administration of FSA and HRA plans.
Review and adjudicate claims, including receipt verification and debit card claims review.
Ensure accuracy and compliance in claims processing.
Respond to client questions and provide claim-related support.
Learn and apply COBRA regulations and requirements.
Set up and maintain new and existing COBRA clients.
Generate daily COBRA notices and process monthly remittances.
Maintain the COBRApoint platform.
Provide customer service and administrative support related to COBRA programs.
Learn and effectively utilize the Employee Navigator platform.
Manage the setup and maintenance of client accounts.
Support clients and internal staff with day-to-day platform navigation.
Establish and maintain carrier and platform integrations.
Support the preparation and distribution of compliance-related documents.
Learn and assist with Forms 1094, 1095, 5500, and 720.
Utilize compliance software to generate required documentation.
Stay informed of regulatory updates and changing compliance requirements.