Sales Service Specialist  IV

Job Description

This individual contributor position ensures accuracy and timeliness for multi-market customers in the National and Multi-State lines-of-business.

In addition to the responsibilities listed below, this individual contributor position is also responsible for ensuring enterprise-wide efficiency, accuracy,and timeliness in driving successful, customer-focused key performance indicators. This may include, but is not limited to leading audits of benefit, rate and structure accuracy at the market and subgroup level; collaborating with internal functional partners to research and resolve issues; contributing to root cause analysis to identify process improvement opportunities; adapting to process improvement; and identifying and escalating issues as appropriate.

Essential Responsibilities

• Responsible for contributing to the execution of standard processes in an efficient, accurate, and timely manner to ensure successful, customer focused key performance indicators. This may include, but is not limited to implementation of benefits, rate and structure accuracy at the market and subgroup level, and researching and resolving issues.
• Contributes to the administration of benefits and products by: implementing routine and non-routine internal business processes related to the benefits and product offering that Sales and Account Management teams are presenting to customers; contributing to and identifying appropriate information on the proposed health insurance benefits and product offerings and recommending resolutions for follow-up questions with cross-team peers; and utilizing advanced knowledge of benefits policies to ensure that all alternate benefit requests meet benefit requirements and state and federal regulatory requirements.
• Assists in effective communication practices by: attending and participating in external and/or internal engagements and assisting team members and managers making formal presentations to various audiences; seeking and providing guidance on general information to ensure that other team members are informed and up to date on important information and influencing events; and utilizing advanced knowledge when completing assigned tasks to assist in developing content and communications to align messages or to advance the sale.
• Helps ensure sales data are used advantageously by: applying relevant processes and procedures to assist with small-scale and medium-scale data entry, reconciliation, and processing in various applicable departmental systems as appropriate to ensure integrity and reliability in data; and utilizing non routine and standard processes to conduct analyses for reporting on lead/prospect/customer accounts, sales, channels, activities, and/or events to inform the team’s strategic recommendations (e.g., membership and account trends) and action plans.
• Contributes to a positive lead/prospect/customer and/or channel partner experience by: developing protocols and strategies to build upon and leverage existing relationships with internal stakeholders, lead/prospect/customer, channel partners, and third-party administrator (TPA) to demonstrate value and build commitment independently; reviewing data about lead/prospect/customer and/or channel partner needs, independently reviewing data on customers’ needs, and identifying solutions that link to our mission, vision and values, service quality, and current product and service offerings; utilizing advanced knowledge of the relevant products, services, and ratings to respond to, encourage, and educate leads/prospects/customers, brokers, and consultants about added services and product enhancements in new, non routine, and varied situations; and collaborating between teams to identify opportunities to better meet the needs of leads/prospects/customers and/or channel partners.
• Contributes to project management efforts by: following pre-established plans for project logistics (e.g., process enhancement initiatives),including time and resource management, and quality checks, with some guidelines; collaborating within team, with cross team, and sometimes cross-organization peers to meet deadlines, applying relevant processes and procedures to resolve new, varied, and non-routine lead/prospect/customer and/or channel partner questions, and escalating critical issues and discrepancies when needed; developing routine protocols to partner with others when reviewing goals, deliverables, and key milestones for project components; completing self directed tasks to support in the strategic direction of projects and executing action plans independently; and applying routine, non-routine, and varied methods/processes for the continuous improvement of tools, technology, and processes to optimize effectiveness.
• Supports the sales process execution efforts by: reviewing and processing incoming lead/prospect/customer and/or channel partner information for Sales Account and Management colleagues; assisting the team to execute all address non-routine, new, and varied business processes related to lead/prospect/customer and/or channel partner requests; supporting and contributing to the communication of information on progress, process, and requirements for lead/prospect/customer and/or channel partner information in a timely manner; independently applying strategies to align lead/prospect/customer and/or channel partner requests and engagement strategies to address non routine, new, and varied challenges; and participating in the maintenance and development of comprehensive and compelling responses to lead/prospect/customer and/or channel partner requests which effectively position, differentiate, brand, and promote our diverse range of products and services

Minimum Qualifications

• Minimum three (3) years account service experience and/or case installation/implementation within the health insurance industry.
• Minimum one (1) year of experience with employee group benefits.
• High School Diploma or GED, or equivalent AND minimum three (3) years of experience working in a corporate or business office environment, which can include relevant internship experience OR Minimum four (4) years of experience working in a corporate or business office environment.                                                                     

Additional Requirements

• Microsoft Office 365 proficiency, demonstrated organizational skills, detail-oriented, etc.

Licenses and Certifications

• Not required to have a healthcare license.

Preferred Qualifications

• Two (2) years group insurance experience.
• One (1) year of experience in underwriting processes, healthcare products and/or contracts.
• Two (2) years experience in one or more of the following areas: provider billing, claims administration, provider relations, provider contracting, revenue cycle finance, and/or data analytics.
• Two (2) years project/program management experience.
• Two (2) years experience working in a remote environment.
• Two (2) years consulting experience.
• One (1) year of experience in project management.
• One (1) year of experience in health care or another heavily regulated industry (e.g., Banking).
• One (1) year of experience in the insurance industry.
• One (1) year of experience with employee group benefits.                                                                     

Benefits                                                 

• Transportation.
• Life insurance.
• Medical insurance.
• Solidarity association.
• Growth plans.
• Additional days off  

K4 – KP000030