20 days old

TEST ONLY FOR PHENOM DO NOT APPLY

Excellus Health Plan Inc.
Buffalo, NY 14202
  • Job Code
    TESTO008391
Summary

This role ensures prompt, accurate, and efficient servicing of all broker, consultant, member and group administrator inquiries for all product lines. Inquiries received by an Account Service Consultant may be via telephone, email, written inquiries, and lobby walk-in customers or through on-site visits with a broker, consultant or employer group. The Account Service Consultant maintains constant communication with the Sales staff, as well as offers valuable information to group accounts. The incumbent is responsible for the implementation of new groups and the renewal and conversion of groups to new product lines, and interact with Operations, Customer Care, Claims and Finance/Underwriting Departments regarding group implementations and renewals and to identify and resolve client account issues.

Essential Responsibilities/Accountabilities

Level I

Researches, interprets and responds to inquiries from internal and external customers, business partners, brokers, consultants, and groups concerning our products, services and policies in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements.

Responds to sales/retention team requests for assistance in the field and provide support where needed regarding new and existing business activity to include completion of group information.

Assists with the development and implementation of new groups or converted groups as directed.

Identifies and responds to issues as brought forward either internally or externally and ensures all inquiries will be responded to within 48 hours and in most cases resolved.

Assures that all account data is maintained on a timely and accurate basis such as initial account setup, benefit books, summaries, contracts, etc.

Services brokers, consultants and employer groups supporting a mix of pre-packaged material as well as custom benefits.

Manages group implementations and supports enrollment meetings.

Assists with escalated issues that may surface within a day.

Responsible for custom, complicated employer groups servicing.

Manages any de-implementations associated with a complex group that terminates from our portfolio when applicable.

Reviews all group-facing documents and validates for accuracy. This can include, but is not limited to, benefit summaries, summary plan descriptions, Member Contracts, Group Agreements, etc.

Partners with Project Management team to support vendor relationships and conversations related to electronic enrollment methods for assigned book of business.

Acts as a liaison between the group/broker/consultant and internal departments when it comes to new group implementations, renewals, escalations, reviews and daily support.

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct and leading to the Lifetime Way values and beliefs.

Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

Regular and reliable attendance is expected and required.

Performs other functions as assigned by management.

Level II - In addition to responsibilities for Level I

Acts as the go-to person along with other Account Service Consultants to coordinate daily activities when necessary.

Assists in the maintenance of files, records, reports and operating manuals.

Assists in obtaining financial, utilization and adhoc reports as requested.

Creates and delivers presentations to external customers.

May train new staff.

Level III - In addition to responsibilities for Level I & II

Identifies issues, patterns and/or trends generated by external and internal action affecting customer satisfaction and consistently and independently recommends and initiates changes and improvement as a result of process review.

Attends meetings and/or trainings as a representative of the Account Service Team and shares the information learned with the Account Service Staff within a reasonable period of time.

Handles HIPAA (Health Information Portability and Accountability Act) issues as requested by members through Group Administrators. Specifically, handles all Designated Record Set (DRS) requests and may serve as a point person for the Account Service team when difficulties arise in obtaining information through normal channels.

Acts as a back up to Account Manager when individual is out of the office.

Assists with on-the-job training of other Account Service and Sales Associates as requested.

Attends provided/necessary training to support job role/function and attends meetings as necessary in order to disseminate information to the Sales and the Account Service staff.

May create rate requests for proposals.

Minimum Qualifications

NOTE

We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

All Levels

Associate's degree in related field with a minimum of one year relative work experience. In lieu of degree, a minimum of 2 years of experience in service or healthcare industries.

Knowledge of operating systems.

Knowledge of NYS and Federal regulations and underwriting policies and all process flows.

Strong oral and written communication skills.

Excellent computer skills required, including the ability to navigate in a Windows environment, database functions and any sales force automation software applications.

Skillful at working between multiple programs and applications at the same time.

Demonstrates expertise in problem-solving skills necessary to accurately and efficiently resolve customer inquiries in an organized manner, resulting in superior accuracy and production levels, and retention of subscriber contracts.

Maintains a professional and courteous attitude at all times towards co-workers, internal and external customers, representing Health Plan, its products, policies and procedures in a positive and professional manner.

Must complete required internal Medicare Training per Center for Medicare Services within one year of start date.

Ability to maintain effective working relationships across the organization.

Valid NYS Life, Accident and Health license within six months of employment required and ongoing completion of Continuing Education requirements. Incumbent will be ineligible for incentive compensation until license is received.

Level Il - in addition to requirements above:

Consistent rating of "Performing" or above

A minimum of two years of relevant experience working in Account Sales/Service/Broker environment.

Completed all necessary training

Ability to efficiently resolve complex & escalated issues with minimal direction.

Advanced system and navigational skills.

Expanded communication skills across multiple channels including, but not limited to, voicemail,

email, outbound calls, membership growth, retention, etc.

Expanded communication skills across the organization including but not limited to, Customer Care, Enrollment, Finance, Underwriting, etc.

Takes accountability and ownership of issues and resolution with minimal supervision.

Thorough knowledge and expertise of benefit programs for all Health Plan business required.

Consistently trains other Account Service team members in order to initiate resolution to all outstanding and/or difficult issues.

Level III - in addition to Level II requirements:

Self-sufficient in resolving complex & escalated issues.

A minimum of three years of relevant experience working in Account Sales/Service/Broker environment.

Provide mentoring and support to new hires and peer group.

Assist with tasks assigned by management that require advanced problem-solving skills.

Demonstrated global thinking and takes initiative to recognize opportunities within the team.

Demonstrated ability to present to various levels of leadership, groups and/or brokers/consultants.

Demonstrated proficiency in quoting process, as well as benefit selection tools.

Knowledge proficiency in rate/renewal.

Demonstrated ability in holding employee health fairs and answers questions on products and benefits.

Demonstrated ability and knowledge to conduct training to brokers and consultants on product portfolio, including ancillary lines.

Participated in meetings that will have an impact on producer channels.

Physical Requirements

Ability to travel as necessary in order to offer support for on-site visits to groups/brokers, open enrollments, training and/or off-site meetings.

**********

The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer





Posted: 2022-09-09 Expires: 2022-10-08
Sponsored by:
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Sponsored by:
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TEST ONLY FOR PHENOM DO NOT APPLY

Excellus Health Plan Inc.
Buffalo, NY 14202

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