ConnectiCare is a leading health plan in the state of Connecticut. ConnectiCare’s mission is to make it easy for members to get the care they need. A local company for over 35 years, ConnectiCare has a full range of products and services for businesses, municipalities, individuals and those who are Medicare-eligible. A subsidiary of EmblemHealth, ConnectiCare leads the individual and small group markets in the state, and is ranked among the top commercial health plans in the nation, according to the National Committee for Quality Assurance.
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We’re looking for individuals who want to make a difference in the communities we serve. If you want to join a local team and help change the way health care is delivered, ConnectiCare is the place for you.
SUMMARY: Represent ConnectiCare in face to face settings to provide high quality service to members and prospects seeking sales and service information and assistance. Act as a customer advocate for delivery of high quality, accurate, concise, proficient and professional assistance in our retail stores. Serve as a sales consultant for prospects and manage retention efforts for current members in obtaining and securing new and renewal business as presented within the store for all Individual product lines. Educate our members and individual prospects on healthcare benefits, processes and tools to improve their healthcare understanding and knowledge.
RESPONSIBILITIES:
- Understand and maintain excellent working knowledge of all ConnectiCare products and services. Must be proficient regarding benefits, coverage, billing, payments and claim policies and procedures.
- Establish trust and deliver a positive customer experience for all members and prospects to create a superior experience and establish the ConnectiCare retail center as the preferred venue for seeking solutions to non-clinical healthcare needs.
- Provide consultative sales for new and renewing customers seeking ConnectiCare health and ancillary insurance products and information.
- Provide a customer friendly service experience for customers with questions regarding health care, health insurance (benefits, claims, premium payments, prior authorizations, prescription medications and enrollment) or other related topics.
- Understand and adhere to all Medicare compliance requirements while conducting sales and service activities.
- Understand and adhere to all Commercial SOLO and Connecticut Exchange (AHCT) requirements and systems while conducting sales and service activities. Successfully interact with AHCT on behalf of our customers to address a wide range of exchange issues including, but not limited to, AHCT systems problems, untrained AHCT call center staff and AHCT staff not familiar with their processes and rules.
- Act as customer advocate in providing assistance to resolve members’ issues and problems.
- Have face-to-face interaction with customers as well as respond to telephone and web-based inquiries as needed.
- Maintain a relationship with customers through outbound calls and other communications to ensure that all client needs are being met and to further enhance the customer experience.
- Use web-based tools and other aids to facilitate and educate customers to use resources and tools. To provide information on their health care benefits and services as well as enable members to manage their health care costs most effectively.
- Follow-up on leads from prospects and renewing members that were presented in the center for possible new sales opportunities which includes telephonic follow-up.
- Assist with conducting group and individual information sessions such as new and renewal retention meetings for Medicare and Commercial prospects and members.
- Maintain flexibility to work in different Center locations to ensure appropriate levels of staffing for all Center locations
- Deliver, coordinate and provide support for special events and projects for ConnectiCare members and the general public in the ConnectiCare Center locations as well as other entities and venues to support the Member Outreach Team and Retail Operations.
- Perform other related duties as required including support to the Call Center and generation of traffic into the Retail Center.
Required Skills
QUALIFICATIONS:
- Post High School education/training or equivalent combination of education and experience required; Bachelor's degree in Marketing or related field preferred.
- Three (3) or more years of previous customer service and/or sales experience in a healthcare organization, medical office. Experience with health insurance products to include individual commercial and/ or Medicare plans.
- Must possess appropriate state Health Insurance License or obtain license within 60 days of hire.
- Must be trained and certified by AHCT to sell exchange products.
- Experience using Microsoft office products, including Word, Excel, PowerPoint, as well as other Internet and web-based tools. Experience preferred in Compass or Amisys.
- Ability to work flexible hours to include evenings and weekends.
- Bilingual in Spanish/English preferred. Excellent oral, written communication and interpersonal skills required.
- Knowledge of ICD-10 diagnosis, CPT-4, UB82 revenue codes, UB92 revenue coding and procedural coding preferred.
- Ability to perform in retail environment with extended periods of sitting, using telephone, viewing computer screens, standing, reaching, lifting files, binders, computer reports.
- Prior retail experience preferred.
- Moderate to heavy keying
ConnectiCare is an equal opportunity employer. M/F/D/V
ConnectiCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Required Experience