Health Plan Sales Associate II

CareSource

36d

About The Position

The Health Plan Sales Associate II is responsible for identifying and education consumers about the CareSource exchange product lines, generating enrollment leads and referrals, supporting enrollment of eligible consumers in the CareSource plan, and facilitating enrollment growth in the product. Essential Functions: Assist prospective members with selecting and enrolling in the CareSource exchange health plan by educating members on our benefits and services, educating members on plan premiums, co-pays and coinsurance, answering all Healthcare Exchange inquiries, assisting with the application process for enrollment., serving as a subject matter expert on CareSource exchange healthcare plans and product lines Assist members with navigating the healthcare system by educating members on our benefits and services, ordering member ID cards, resolving pharmacy inquiries, resolving escalated member complaints, consulting with support departments for expedited resolution, and informing members of premium payment options May be required to make proactive outbound sales calls based on identified leads or campaigns to our prospective members to assist them with enrolling in the CareSource Just4Me product Ensure all HIPAA and State/CMS requirements and regulations are adhered to at all times Maintain complete and accurate documentation of all communications with members and prospective members Ensure all HIPAA guidelines are adhered to on every interaction Ensure PCI compliance while processing payment requests Maintain regulatory knowledge for compliance to ODI, CMS, and CareSource requirements Build and strengthen member relationships by providing world class customer service Maintain knowledge and understanding of all processes and procedures Research, follow up, and resolve all open/pended issues in a timely manner to ensure member satisfaction Make contact with potential members and successfully quote their insurance premiums Build long-term relationships with members Service and provide information regarding applicable changes to their policy Adhere to all departmental and company policies and procedures Perform any other job related instructions, as requested

Requirements

High School Diploma or General Equivalency Degree (GED) required
Minimum of three (3) years of customer service, sales support or other related experience is required
Computer proficiency with knowledge and experience in a Windows environment
Typing speed of 35 words per minute (WPM)
Maintain regulatory knowledge for compliance to ODI, CMS, and CareSource requirements
Strong written and verbal communication skills
Professional phone etiquette
Proper use of grammar
Ability to work in a fast paced environment
Adaptable to a constantly changing environment
Customer service experience
Solid self-management and time management skills
Ability to work effectively independently and within a team environment
Critical thinking and listening skills
Decision making and problem solving skills
Demonstrates confidence and positivity
Sales skills to meet enrollment objectives
Professional telemarketing skills
Current, unrestricted State Insurance license in Accident and Health in state of practice within state(s) of assigned territory is /are required or ability to achieve license(s) within 30 days of hire
If a Federally-Facilitated Marketplace (FMM) State, certification from the Health Insurance Marketplace and annual recertification each year thereafter is required

Nice To Haves

Associate’s degree or equivalent years of relevant work experience is preferred
Commercial insurance sales experience is preferred

Responsibilities

Assist prospective members with selecting and enrolling in the CareSource exchange health plan by educating members on our benefits and services, educating members on plan premiums, co-pays and coinsurance, answering all Healthcare Exchange inquiries, assisting with the application process for enrollment., serving as a subject matter expert on CareSource exchange healthcare plans and product lines
Assist members with navigating the healthcare system by educating members on our benefits and services, ordering member ID cards, resolving pharmacy inquiries, resolving escalated member complaints, consulting with support departments for expedited resolution, and informing members of premium payment options
May be required to make proactive outbound sales calls based on identified leads or campaigns to our prospective members to assist them with enrolling in the CareSource Just4Me product
Ensure all HIPAA and State/CMS requirements and regulations are adhered to at all times
Maintain complete and accurate documentation of all communications with members and prospective members
Ensure all HIPAA guidelines are adhered to on every interaction
Ensure PCI compliance while processing payment requests
Maintain regulatory knowledge for compliance to ODI, CMS, and CareSource requirements
Build and strengthen member relationships by providing world class customer service
Maintain knowledge and understanding of all processes and procedures
Research, follow up, and resolve all open/pended issues in a timely manner to ensure member satisfaction
Make contact with potential members and successfully quote their insurance premiums
Build long-term relationships with members
Service and provide information regarding applicable changes to their policy
Adhere to all departmental and company policies and procedures
Perform any other job related instructions, as requested