Health Plan Sales Associate II

Job Summary:

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

Education and Experience:

• High School Diploma or General Equivalency Degree (GED) required
• Associate’s degree or equivalent years of relevant work experience is preferred
• Minimum of three (3) years of customer service, sales support or other related experience is required
• Commercial insurance sales experience is preferred

Competencies, Knowledge and Skills:

• 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

Licensure and Certification:

• 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
• Certification Requirement within state(s) of assigned territory:
  • If a Federally-Facilitated Marketplace (FMM) State, certification from the Health Insurance Marketplace and annual recertification each year thereafter is required

Working Conditions:

• Will work in a phone queue; required to sit/stand for long periods to time
• Required to use general office equipment, such as a telephone, photocopier, fax machine, computer
• General office environment; may be required to sit/stand for long periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.