Broker Concierge Sales and Service Associate II
About The Position
The Broker Concierge Sales and Service Associate II serves as a dedicated operational advocate for CareSource’s highest-performing brokers, agencies, and FMOs. The role provides personalized support by managing complex pre- and post-enrollment issues, including member onboarding, provider and network inquiries, benefits and eligibility questions, billing issues, and service escalations through resolution. The associate researches and resolves broker and member issues, aiming for first-call resolution or managing cases through completion. The role works virtually with other departments and business owners, researches information across vendor systems, health plan sites, portals, internal resources, and custom tools, and identifies root causes and barriers. It also supports prospective members with CareSource exchange plan selection and enrollment, explaining benefits, services, premiums, copayments, and coinsurance and assisting with applications. The position requires accurate documentation of broker interactions, follow-up on unresolved dental, pharmacy, and other benefit inquiries, and compliance with departmental and company policies. The role operates in a general office environment and uses a phone queue and general office equipment. Travel is not typically required.
Requirements
- High school diploma or GED.
- Three years of customer service, sales support, or other related experience.
- Computer proficiency and experience in a Windows environment.
- Typing speed of 35 words per minute.
- Maintain regulatory knowledge for compliance with ODI, CMS, and CareSource requirements.
- Strong written and verbal communication skills.
- Professional phone etiquette and proper use of grammar.
- Ability to work in a fast-paced, constantly changing environment.
- Customer service experience.
- Solid self-management and time-management skills.
- Ability to work effectively independently and within a team.
- Critical thinking and listening skills.
- Decision-making and problem-solving skills.
- Confidence and positivity.
- Sales skills to meet enrollment objectives.
- Professional telemarketing skills.
Nice To Haves
- Associate degree.
- Commercial insurance sales experience.
- Current, unrestricted State Insurance license in Accident and Health in the state of practice within the assigned territory, or ability to obtain required license(s) within 30 days of hire.
- For a Federally-Facilitated Marketplace state, Health Insurance Marketplace certification and annual recertification.
Responsibilities
- Research and resolve issues across the pre- and post-enrollment process for broker enrollees, focusing on first-call resolution or ongoing case management through resolution.
- Collaborate virtually with departments to resolve member issues and broker escalations.
- Independently complete broker-related research, fulfillment, and inquiry requests efficiently and promptly.
- Access and extract data from primary and secondary sources in various formats as part of issue resolution.
- Research ancillary vendors, third-party systems, health plan sites, portals, internal reference materials, and custom tools to verify information and identify root causes.
- Process aging inventories of broker and member requests promptly and effectively through full resolution.
- Work with business owners to identify root causes and resolve barriers experienced by members.
- Use benefit coverage resources, tools, and materials to respond accurately to member inquiries and concerns.
- Log broker interactions in appropriate databases for tracking and analysis.
- Troubleshoot escalated member issues reported by brokers.
- Make follow-up calls to members and brokers about unresolved dental, pharmacy, and other benefit inquiries, including processing pharmacy overrides and rejections.
- Follow departmental and company policies and procedures.
- Assist prospective members with selecting and enrolling in CareSource exchange health plans by explaining benefits, services, premiums, copayments, and coinsurance, answering exchange inquiries, and assisting with applications.
- Serve as a subject matter expert on CareSource exchange healthcare plans and product lines.
- Perform other job-related duties as requested.
Benefits
- May qualify for a bonus tied to company and individual performance.
- Substantial and comprehensive total rewards package.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
