What are the responsibilities and job description for the Customer Service Ops Admin - TPA position at Mashantucket Pequot Tribal Nation?
The TPA Customer Operations Administrator manages the operations for commercial customers’ claims and operating accounts. This role ensures accurate tracking and data entry of premium payments, claim funding, and Stop Loss reimbursements within the VBA claims system. Oversee customer fund balances, audit Commercial customer invoices, and serve as a vital operations liaison for internal teams and commercial customers. Associate’s degree in Accounting, Finance, or Business Administration required. 2 years in billing, insurance financial operations, or third-party administration (TPA). Experience with TPA processing systems is a plus.
• Input commercial premium payments and administrative fees into the VBA claims system promptly.
• Log commercial customer claim deposit amounts accurately to ensure continuous coverage.
• Track and record Stop Loss reimbursements directly linked to customer claims.
• Maintain and update detailed customer fund balance reports.
• Review and audit monthly commercial premium and fee billings to ensure total accuracy.
• Distribute claim funding requests and monthly premium invoices to clients on schedule.
• Provide timely internal support regarding customer billings, fund balances, and related inquiries.