Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)

• Build and maintain strong, long-term relationships with key clients and their broker partners. • Conduct regular in-person client and broker visits to strengthen relationships and identify opportunities for added value. • Lead internal strategy meetings for high-risk or "jeopardy" accounts to proactively address issues and preserve client satisfaction. • Facilitate weekly touchpoints with assigned Account Manager (AM) and Client Service Specialist (CSS) to review client health and prioritize issue resolution. • Participate in weekly Client Services leadership meetings to resolve escalated items and align on client strategy. • Serve as the point of escalation for complex issues that cannot be resolved at the AM level. • Monitor performance guarantees and ensure timely delivery of required reporting to clients. • Partner with the Analytics team to develop storylines and insights for Annual Plan Performance Reviews. • Present performance reports and strategic recommendations to clients and broker partners. • Contribute to content development and data analysis for Quarterly Review Updates. • Drive the optimization and standardization of workflows, service processes, and department documentation. • Support organic growth through upselling ancillary lines and targeted solutions. • Leverage broker relationships to facilitate new growth opportunities. • Deliver renewal proposals as part of a consultative, data-driven discussion with clients and brokers to support strategic decision-making. • Collaborate with internal stakeholders to evaluate plan design changes and develop strategic recommendations. • Track renewal opportunities and activity within Salesforce. • Partner with internal teams to determine rate actions and above/below-the-line increases.

• Serve as a primary contact for day-to-day client inquiries and service needs. • Collaborate with internal teams to resolve complex issues and deliver timely, accurate responses. • Communicate updates related to high-cost claimants, notable claims activity, service issues, and plan performance to internal and external stakeholders. • Troubleshoot and resolve a variety of client and member issues, including claims, eligibility, Rx discrepancies, ID cards, and utilization review concerns. • Coordinate and distribute standard and ad hoc client reports. • Support the development and delivery of quarterly review materials and other client-facing updates. • Identify service gaps or trends and proactively escalate concerns to senior team members. • Track status of outstanding items and ensure closure through proper documentation and communication.

• Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims. • Review, apply and create refund letters for all lines of business to members and providers. • Reprocess payments when necessary. • Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions. • Review plan documents for various groups to research and resolve claim processing questions and issues. • Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request. • Perform other related duties, as assigned.

• Ensure accuracy of claims adjudication while maintaining quality and turn around goals. • Adjudicate medical, dental and vision claims. • Review plan documents for various groups to apply appropriate benefits to claims being adjudicated. • Prioritize assigned claims by adjudicating oldest claims first. • Communicate effectively with internal auditors and management team. • Perform other related duties, as assigned.

• Directly manages the Development Operations (DevOps) team of software engineers, report developer(s) and business analyst(s) • Assigns, tracks and evaluates quality of workload, conducts daily, weekly, and 1:1 meetings with development team members • Supports and develops software engineers by providing advice, coaching, code reviews and educational opportunities • Develop software solutions by studying information needs, conferring with users, studying systems flow, data usage, and work processes • Document and demonstrate solutions with flowcharts, layouts, diagrams, charts, code comments, and clear code • Prepare and install solutions • Improve operations by conducting systems analysis and recommending changes in policies and procedures • Protect operations by keeping information confidential • Provides information by collecting, analyzing, and summarizing development and service issues

• Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. • Read and interpret benefits to build out the benefit plans by coding, building, revising, and maintaining self-insured healthcare plans in the claims adjudication system. • Ensure that both the plan documents and the plans within the system are aligned with regulatory standards and client specifications. • Collaborate with internal implementation teams, account managers, and other stakeholders to ensure the accurate setup of new plans and updates to existing plans. • Troubleshoot and resolve plan build issues or errors in the claims adjudication system to ensure proper claim processing. • Conduct ongoing research on evolving healthcare regulations and adjust documents and plan builds accordingly. • Provide guidance to junior staff and internal teams on the proper application of plan design principles and system builds.

• Handle high-volume inbound calls with professionalism, empathy, and accuracy. • Provide clear, accurate information regarding health insurance benefits, claims, billing, and eligibility. • Assist members in navigating online resources and submitting requests. • Document all call interactions in customer management systems in compliance with company and regulatory requirements. • Adhere to call handling standards, including average handle time, quality scores, and first call resolution targets. • Follow compliance guidelines including HIPAA, CMS, and state-specific regulations. • Escalate complex issues appropriately to ensure timely resolution. • Stay current with updates to health plan policies, systems, and processes. • Contribute to continuous improvement by identifying trends and opportunities for enhanced customer experience.