Broker Concierge Sales and Service Associate II

This is a fully remote position, open to applicants in Ohio.

📋 Description

• Act as a dedicated operational representative for CareSource's top brokers, agencies, and FMOs.

• Offer high-touch, tailored support for intricate pre- and post-enrollment challenges.

• Investigate and resolve issues related to member onboarding, provider and network concerns, benefits and eligibility, billing, and service escalations.

• Manage cases until final resolution, with an emphasis on first-call resolution.

• Collaborate remotely with various departments to address member issues and broker escalations.

• Fulfill broker-related research, requests, and inquiries.

• Retrieve and extract data from primary and secondary sources in multiple formats.

• Investigate ancillary vendors, third-party systems, health plan websites, portals, internal reference materials, and custom tools.

• Address aging broker/member request inventory through comprehensive resolution.

• Identify root causes and eliminate barriers faced by members.

• Utilize benefit coverage resources and materials to accurately respond to inquiries.

• Document broker interactions in relevant databases for tracking and analysis.

• Resolve escalated member issues as reported by brokers.

• Conduct follow-up calls for inquiries regarding dental, pharmacy, and other benefits.

• Process pharmacy overrides and handle rejections.

• Assist potential members in selecting and enrolling in CareSource exchange health plans.

• Educate members about benefits, services, premiums, copays, and coinsurance.

• Respond to Healthcare Exchange inquiries and assist with enrollment applications.

• Serve as a subject matter expert on CareSource exchange healthcare plans and product offerings.

• Perform additional related duties as requested.

⛳️ Requirements

• High School diploma or GED is required.

• A minimum of three (3) years of experience in customer service, sales support, or other related fields is required.

• Preferred experience in commercial insurance sales.

• Proficient in computer applications with knowledge and experience in a Windows environment.

• Typing speed of at least 35 words per minute (WPM).

• Maintain regulatory knowledge to ensure compliance with ODI, CMS, and CareSource standards.

• Excellent written and verbal communication skills.

• Professional phone etiquette is essential.

• Proper grammar usage is required.

• Ability to thrive in a fast-paced environment.

• Adaptable to an ever-changing work environment.

• Previous customer service experience is necessary.

• Strong self-management and time management skills are needed.

• Ability to work effectively both independently and as part of a team.

• Critical thinking and active listening skills are essential.

• Strong decision-making and problem-solving abilities.

• Sales skills necessary to meet enrollment goals.

• Professional telemarketing skills are preferred.

• A current, unrestricted State Insurance license in Accident and Health may be required in the state of practice, or the ability to obtain the license(s) within 30 days of hire.

• Health Insurance Marketplace certification and annual recertification are preferred for Federally-Facilitated Marketplace states.

🏝️ Benefits

• Bonus opportunities linked to both company and individual performance may be available.

• A comprehensive total rewards package.

• Support for employee well-being.

• Opportunities for remote work arrangements.