1 Sales Executive, Health Insurance Job in Lancaster, PA

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Sales Executive, Health Insurance

Preferred Health Care

Lancaster, PA | Full Time

$63k-83k (estimate)

3 Weeks Ago

Sales Executive, Health Insurance

$63k-83k (estimate)

Full Time 3 Weeks Ago

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Preferred Health Care is Hiring a Sales Executive, Health Insurance Near Lancaster, PA

SUMMARY
To provide superior service and support to all customers through the acquisition of proficient
knowledge of all departments in order to provide fast and courteous service to our providers,
employer groups and clients. The end result of which will be the elimination of the misdirection
of customers, a superior customer experience and above average customer satisfaction.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

Answers all initial telephone calls and provides requested information (including, but not

limited to):
o Claim status and discount questions
o Provider participation requests for inclusion in the network
o Assist clients, subscribers, and providers with inquiries and problem solving

Ensures superior client service experience by personally assisting and ensuring all client

needs are addressed and answered completely upon inquiry. Impact the company’s bottom
line by turning frustrated clients into repeat customers.

Serves as primary escalation contact for account managers and responsible for collaborating

with them to resolve and implement any service recovery measures to address customer
disruptions.

Will meet or exceed all quality assurance measures as outlined by the Supervisor or company.
Log all calls and complaints into Access Complaint/CSR Log database.
Handle insurance verification calls from providers while focusing on first call resolution.
Requires the ability to interact with difficult clients, members, and/or providers.
Repricing of claims and all related processes
Processing and adjudication of claims.
Provide appropriate solutions and alternatives in a prompt manner and follow up as necessary

to confirm service resolution.

Import EDI claims and resolve errors in EDI batches.
Prepare, print and mail monthly access fee invoices.
Manage “Waiting for Faxes” report and perform follow up as needed with providers.
Email appropriate Manager about department complaints. Ensure timely complaint

resolution for all service inquiries received.

Studies and recommends standardized procedures to improve efficiency of their department

to Supervisor.

Responsible for staying updated on product knowledge as well as changes in company policy.
Manage incoming faxes and distribute to appropriate personnel.
Meet personal and team goals for productivity.
Collates and distributes daily Benefit Statements to payors.
Maintains comprehensive working knowledge of all company departments, their functions,

and the way they inter-relate to each other.

Act as backup support for Administrative Support Specialist and provide coverage for front

desk as needed.

Other duties as assigned.

QUALIFICATIONS
To perform this job successfully, Customer Service Representatives must be able to perform each
essential duty satisfactorily. The requirements listed below are representative of the knowledge,
skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
Must possess the willingness to learn multiple department functions to adequately answer
incoming calls and provide accurate answers.
Requires the ability to interact with difficult clients, members, and/or providers in a courteous,
professional manner.
EDUCATION and/or EXPERIENCE
Associate’s degree (A.A.) or equivalent from a two-year college or technical school; or six
months to one-year related Customer Service experience; or equivalent combination of education
and experience.
Must be proficient in Microsoft platform applications (Word, Excel, and Access database).
Experience in processing claims is helpful, but not required.
LANGUAGE SKILLS
The position will require the ability to read and interpret instructions and procedure manuals;
ability to interpret routine reports and correspondences and the ability to speak effectively and
professionally to clients, providers, and employer groups. Strong customer service orientation
with active listening skills and a high attention to detail with professional verbal and written
skills. Ability to explain policy provisions and other insurance related manners to lay customers
in a clear and concise fashion
MATHEMATICAL SKILLS
Ability to calculate figures and amounts such as discounts, interest, and percentages.
REASONING ABILITY
Ability to solve practical problems and deal with a variety of concrete variables in situations
where only limited standardization exists. Ability to interpret a variety of instructions furnished
in written, oral, or scheduled form. Ability to apply a comprehensive knowledge of PHC and its
products and services as necessary to provide superior service to all customers.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee
to successfully perform the essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit. Specific vision
abilities required by this job include close vision, and ability to adjust focus during computer
operation.

WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee
encounters while performing the essential functions of this job. Reasonable accommodations may
be made to enable individuals with disabilities to perform the essential functions.
Activities performed at a fast pace in an oriented office environment.
At times employee may need to interact with difficult clients, members, and/or providers.