Duties and Responsibilities:
- 30% - Support Large and Major Market group sales via creation and submission of prospect and renewal quote requests, including production of final proposal documents. These duties may include but are not limited to the following: Submit prospect and renewal quotes for Medical, Rx, Dental, Vision, Assist with Stop Loss quotes if the Medical/Rx benefit designs are needed by Rating. Submit and monitor requests for all non-standard benefits, communicate approvals/denials with Sale Exec and initiate the appeal process when necessary. Create Medical/Rx, Dental and Vision Highlight sheets for quoted benefits.
- 35% - Process post-sale internal paperwork for new Large and Major Market group enrollments. These duties may include but are not limited to the following: collaborate with Sales to acquire all necessary paperwork and scrub for accuracy, create and Submit Pharmacy forms for all Rx benefits sold. Maintain accurate logging within the Large Group tracking log in SharePoint. Upload all required paperwork into the Large Group Library. Send acquired group paperwork to specified areas for processing. Submit SRS requests to IT&D for any group requesting deductible credit/proration. Update Highlights sheets with any applicable post-sale benefit changes.Create/Process SBC documents timely to meet compliance requirements.
- 10% - Prepare and submit internal paperwork for active Large and Major Market group renewals, benefit changes, demographic and structural changes throughout the year. These duties may include but are not limited to the following: Collaborate with Sales to acquire all necessary paperwork and scrub for accuracy. Update and Submit Pharmacy forms for all Rx benefits. Maintain accurate logging within the Large Group tracking log in SharePoint. Upload all required paperwork into the Large Group Library. Create yearly renewal highlight sheets with any applicable benefit changes and provide to Case Underwriting. Create/Process yearly renewal SBC documents with any applicable benefit changes timely to meet compliance requirements.
- 25% - Schedule meetings with Sales Rep as needed to resolve any questions/issues while generating quotes, proposals or handling post-sales group paperwork.
- 5% - Maintain group data integrity within Maris and/or Salesforce.
- 5% - Research and respond to inquiries and/or assigned Group Escalation cases from Sales and other internal operational units.
- 10% - Attend benefit and operational issue resolution meetings with Sales, Group Implementation and other operational areas, when requested.
- 5% - Create benefit deviation documents when requested for RFPs.
- 5% - Represent Sales Services on a designated departmental or small project team or in meetings that require feedback on use of technology and/or process.
Skills:
- Ability to work independently and to plan/prioritize workload.
- Strong ability to multitask, work in a fast-paced environment, and meet deadlines.
- Good administrative, organizational, and problem solving skills.
- Strong written and verbal communication skills with the ability to interface with Sales and other operational units with professionalism and tact.
- Must be extremely detail-oriented.
- Demonstrated ability to assess issues and provided recommended solutions to fix problems.
- Adherence to operational processes and established processing standards.
- Strong interpersonal and relationship management skills.
- Committed to developing skills and knowledge.
- Perseverance and a ‘can-do’ attitude.
Knowledge:
- Familiar with benefit programs administered and/or supported by Capital Blue Cross and its subsidiaries.
- Knowledge of sales guidelines, benefits administration policies, enrollment and billing processes, claims processing and general operating procedures.
- Familiarity with operational processing systems utilized throughout Capital’s business operations, such as MARIS, Salesforce, and FACETS.
Experience:
- 3 years’ experience in health insurance, operational or marketing support or a related field.
- Experience with PC-based software packages (MS Word, MS Excel, MS Access, and MS SharePoint)
- Demonstrate understanding of Sales systems (Maris and Salesforce)
Education and Certifications:
- High school diploma or GED.
Physical Demands:
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds.
Other: