The purpose of this position is to support a retail store customer experience by servicing and selling health insurance products that meet customers’ needs and by building customer relationships that contribute to retention and customer loyalty.

This position is responsible for providing in-person consultative sales and service for customers seeking health and ancillary insurance products including Medicare, individual, small business, dental, vision and more. Additionally, this position supports a customer-focused environment by providing a caring and friendly service experience for customers with questions or issues related to their Capital Blue Cross health insurance (benefits, claims, premium payments, enrollment, etc.) or other related topics.

In addition to general sales and service, the Retail Center Sales and Service Representative II handles more complex customer service issues as well as escalated service problems when supporting the Commercial Group sales team. The representative is responsible for providing efficient, courteous, and professional service to members, providers, group administrators, brokers, plan personnel, and the general public in a timely manner.

• Provide consultative sales and service experience for customers seeking health and ancillary insurance products and information, Including: (a) Use web-based tools and other aids to analyze prospective customer needs and match to appropriate company products and services; (b) Conduct plan comparison and analysis for existing members seeking new solutions; (c) Determine product eligibility based on age, county, health status and customer’s expressed needs; (d) Facilitate application process and perform field underwriting; advise customers of eligibility, rates and riders as appropriate; (e) Present and explain recommended products, benefits, features, and alternatives; (f) Ensure new customers receive orientations/information regarding self-service and shopping tools, incentives and value-added features and information; (g) Contact Small Group customers with a goal to retain and cross sell additional products to the group; (h) Track and report enrollment support activities; and (i) Work in a team based environment to achieve established quarterly and annual goals and key metrics used to gauge store success.
• Provide a customer friendly service experience for customers with questions or issues related to health care, health insurance (benefits, claims, premium payments, and enrollment) or other related topics, including: (a) Research and obtain resolution for all issues using appropriate tools and resources or coordinating referrals with other supporting employees; (b) Log all inquiries, capturing appropriate data required for reporting and customer understanding; (c) Respond to telephone and web-based inquiries and initiate telephonic follow-up when appropriate; (d) Research complicated complaints and collaborate with other areas of the company to resolve issues; (e) Communicate resolution to customer and/or commercial group account executive; and (f) Manage a book of small group customers and serve as the point person for all issues, communications, and day-to-day questions.
• Educate customers on using online tools and resources to manage their health care and health care costs most effectively and support other store activities, special projects and assignments, as needed, including:(a) Conduct orientations for new customers, explaining resources, services and programs as appropriate; (b) Conduct small group seminars on resources and tools for health care shopping, managing employee health, etc.; (c) Explain/promote incentive programs to target customers or prospects, building enthusiasm and support for program participation and answering questions; (d) Participate in event planning meetings and support in-store and community events throughout the year; (e) Support offsite meetings, events and seminars at customer groups and community events; (f) Support special projects and assignments as needed to improve the overall customer experience; (g)Track and report enrollment support activities; and (h) Assist in the training and on-boarding of new employees.

Experience:

• A minimum of 3 years' face-to-face consultative experience.
• Prefer experience in the insurance industry, physician’s office, hospital or other position in the health care industry.
• Prefer experience in store/retail environment.
• Experience with financial products or services.
• 2-3 years' customer service experience/training, preferably within Capital BlueCross or other insurance carrier.
• Prefer experience with Facets claim processing system as well as online files for determining enrollment, billing, and benefits.

Skills:

• Prefer bilingual skills (Spanish).

Knowledge:

• Knowledge of benefit programs administered and/or supported by Capital Blue Cross including individual, Medicare, small business, CHIP, and ancillary products including dental and vision.
• Knowledge of benefits administration policies, customer billing processes, and general procedures.

Education and Certifications:

• Bachelor’s degree in business, Health Policy, Marketing or related field).
• Must possess a PA State Pennsylvania Producer license OR obtain within 90 days of hire AND must obtain sufficient continuing education credits to maintain the license.
• You may be responsible for the care, supervision, guidance, or control of children or otherwise have routine interaction with children. Therefore, in accordance with Pennsylvania’s Child Protective Services Law, you must undergo and obtain clearances through comprehensive and regularly updated criminal and child abuse background checks. Capital BlueCross will assist you in obtaining these clearances.

Locations:

• This position is an onsite position @ PA Saucon Valley Retail Center in the Lehigh Valley PA area.

Work Environment:

• Must be willing to work flexible hours with possible evenings, Saturdays and holidays.

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 occasionally lift and/or move up to 5 pounds.

Travel:

• Requires occasional travel to other store locations throughout Central Pennsylvania and Lehigh Valley with possible overnight stays.

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.