Small Employer/Personal Plans Representative II

Job Description:

Provides understanding and ability in assisting brokers, potential members, and existing members in the sale of Individual Plans and Products. Works with Underwriting Operations, Enrollment, and Billing throughout the sales and renewal process to ensure accuracy and completeness.

February – October:M-F  9:30 – 6:00   

November – January (Open Enrollment:  hours could vary.    Expect some Saturdays and overtime will be required

Preferred skills sets:

• Bi-lingual Spanish
• Active state insurance producers license

Job Essentials

1. Trains and assists brokers and consumers with the sale of Individual and Small Employer Plan Products. This includes the explanation of plans, products, rates, and all available options.
2. Trains employees in the sales and education of all Individual and Small Employer Plan products including all requirements and limitations. Provides recommendations on plan types and options.
3. Acts as a resource for and stays updated on changes in legislation and the health care industry and how it affects the individual health plans market and internal policies. Assists brokers and applicants with this information and how it affects the sale of Individual and Small Employer plans.
4. Attends various sales events. Interacts with brokers, customers, and other department members in a professional manner.
5. Along with handling a specific book of business, assists with other Individual and Small Employer Plan Representative's books of business as needed. This includes corresponding accurately and understandably to customers and brokers in a professional and confidential manner in accordance with HIPAA and internal compliance guidelines.
6. Responsible for corresponding with agents and applicants via the automated system including sending out appropriate approval, declination, withdrawal, closed file letters and condition specific exclusion documents. Corresponds accurately and understandably to customers and communicates information in a professional and confidential manner in accordance with HIPAA and internal compliance guidelines.
7. Resolves problematic application, underwriting, and enrollment issues. Serves as liaison to other departments in order to facilitate quick and efficient problem resolution including handling plan termination requests in a timely manner. Resolves complex benefit issues or complaints referred by Health Benefits Specialists, brokers, customers, or the Appeals department. Informs manager of specific issues and keeps them informed of situation.
8. Inputs data and updates the sales automation system as necessary, ensuring information is accurate and timely.
9. Makes outbound welcome calsls to new plan enrollees as needed.
10. Acts as back up Supervisor as needed including handling escalated phone calls. Provides a resource of information and support to the sales team.
11. Communicates all employee relations issues, concerns, and incidents to Supervisor or Manager.
12. Provides sales training and on-going mentoring to new employees as well as existing staff.
13. Maintains an average phone audit score of 97%.
14. Maintains an average of no more than three RONA calls per month.
15. Does not receive any documented disciplinary action within the last 12 months.


Minimum Qualifications

One year work experience working with individual insurance plans.
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Two years customer service experience.
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Demonstrated beginning knowledge of word processing, spreadsheet programs, and navigating through internet based systems.
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Demonstrated excellent presentation skills and the ability to communicate effectively with Individual Plan and Small Employer applicants and Insurance Brokers.
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Demonstrated detail orientation and strong interpersonal skills, time management skills, problem solving ability, and the ability to work well in pressure situations.
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Demonstrated ability to work well in a team environment.
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Demonstrated strong customer service orientation.

Preferred Qualifications

Two years of experience in the health insurance industry.
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Understanding and functional knowledge of health insurance.
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Facets software or similar eligibility system.
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Excellent presentation skills and the ability to communicate effectively with Individual Plan applicants and insurance brokers.
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Detail oriented and possess strong interpersonal skills, time management skills, problem solving ability, and the ability to work well in pressure situations.
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Ability to work well in a team environment.
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Strong customer service orientation.
 

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