Personal Plans Representative II

• Assist brokers, potential members, and existing members with the sale of Individual Plans and Products
• Train and assist brokers and consumers on Individual and Small Employer Plan products, plans, rates, options, requirements, and limitations
• Train employees in sales and education of Individual and Small Employer Plan products
• Stay current on legislation, healthcare industry changes, individual health plan market impacts, and internal policies
• Attend sales events and interact professionally with brokers, customers, and department members
• Manage a specific book of business and support other representatives’ books as needed
• Correspond with agents, applicants, customers, and brokers through automated systems and send approval, declination, withdrawal, closed-file, and exclusion documents
• Resolve application, underwriting, enrollment, benefit, complaint, and plan termination issues; liaise with other departments and elevate issues to management
• Update sales automation system data accurately and timely
• Make outbound welcome calls to new plan enrollees
• Act as backup Supervisor, handle escalated calls, and support the sales team
• Communicate employee relations issues to the Supervisor or Manager
• Provide sales training and ongoing mentoring to new and existing employees
• Maintain required phone audit and call performance standards

• One year of work experience with individual insurance plans
• Two years of customer service experience
• Beginning knowledge of word processing, spreadsheet programs, and internet-based systems
• Excellent presentation skills and effective communication with Individual Plan and Small Employer applicants and insurance brokers
• Detail orientation, strong interpersonal skills, time management skills, problem-solving ability, and ability to work well under pressure
• Ability to work well in a team environment
• Strong customer service orientation
• Preferred: bilingual Spanish
• Preferred: active state insurance producers license
• Preferred: two years of health insurance industry experience
• Preferred: functional knowledge of health insurance
• Preferred:
  Facets software or similar eligibility system
• Ability to work February–October, Monday–Friday, 9:30–6:00
• During November–January open enrollment, availability for variable hours, some Saturdays, and required overtime
• Ability to maintain an average phone audit score of 97%
• No more than three RONA calls per month on average
• No documented disciplinary action within the last 12 months
• Ability to communicate information, operate computers and office equipment, read computer monitors and documents, and remain sitting or standing for long periods

Demonstrates expertise in Individual and Small Employer Plan products, providing training and support to brokers and consumers while maintaining compliance with industry regulations. Strong customer service orientation and effective communication skills are essential for managing relationships and resolving issues.

• Individual Insurance Plans Experience
• Customer Service Experience
• Sales Training and Mentoring
• Health Insurance Industry Knowledge
• Bilingual Spanish

• Sales Automation System Data Management
• Problem-Solving Ability
• Detail Orientation
• Time Management Skills
• Presentation Skills

• Interpersonal Skills
• Team Collaboration
• Effective Communication

• Active State Insurance Producers License

• Healthcare Industry Changes
• Individual Health Plan Market
• Enrollment Issues
• Underwriting Issues
• Sales Events

• Facets Software
• Word Processing Programs
• Spreadsheet Programs
• Internet-Based Systems