Direct Pay Medicare Account Service Consultant I/II
Capital District Physicians Health Plan Inc, Rochester, NY, United States
Job Summary
The Account Service Consultant ensures prompt, accurate, and efficient servicing of the Medicare Sales team, which includes Medicare Advantage, Medicare Supplement, and Prescription Drug Plans (PDPs). Inquiries may be received via telephone, written inquiries, or lobby walk‑in customers. This position maintains constant communication with the Sales and Management staff and interacts with other departments such as Medicare Operations and Enrollment to identify and resolve client account issues.
Responsibilities All Levels:
Level I:
Researches, interprets and responds to inquiries from internal and external customers, business partners, brokers, and consultants concerning our products, services and policies in accordance with CMS, Corporate Service strategy and other legislative requirements.
Identifies and responds to issues as brought forward either internally or externally and ensures all inquiries will be responded to within 24 hours and are most often resolved.
Attends provided or necessary training to support the job role/function and attends and facilitates meetings as necessary.
Responds to sales team requests for assistance and provides support where needed regarding new and existing business activity. Assures that all account data is maintained on a timely and accurate basis such as initial account setup, benefit books, contracts, etc.
Acts as the go‑to person to coordinate daily activities when necessary and assists with difficult issues that may surface within a day.
Assists in the maintenance of files, records, and operating manuals and provides assistance in obtaining reports as requested.
Attends meetings and/or trainings as a representative of the Medicare Sales or Enrollment Team and shares the information learned with the team.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Level II:
Assists with on‑the‑job training of other Account Service and Sales Associates as requested.
Mentors and trains other account service team members to initiate resolution of all outstanding and/or difficult issues.
Acts as a backup to the Account Executive when the individual is out of the office.
Identifies issues, patterns and/or trends generated by external and internal action affecting customer satisfaction and consistently and independently recommends and initiates changes and improvements as a result of process review.
Reviews all broker/sales‑facing documents and validates them for accuracy, including collateral for broker/sales events.
Takes the lead position in facilitating department‑wide purchase order requisitions.
Qualifications All Levels:
Level I:
Associate degree in a related field; in lieu of a degree, require three years of related experience.
Thorough knowledge and expertise of benefit programs for all health plan business required within six months of employment.
Sales and strong communication skills.
Must have experience working with the senior population.
Demonstrates expertise in problem‑solving skills necessary to accurately and efficiently resolve customer inquiries in an organized manner, resulting in superior accuracy and production levels and retention of subscriber contracts.
Demonstrated sensitivity to interacting and communicating with the Medicare‑eligible market.
Demonstrates knowledge of operating systems, spreadsheet and word‑processing applications, database functions, and any sales‑force automation software applications.
Valid NYS Life, Accident and Health license within six months of employment required.
Complete required Medicare training per CMS within six months of employment.
Level II:
A minimum of two years of experience in an equivalent sales or sales‑operation function is required (e.g., Account Service Consultant, Inside/Field Sales, Medicare Operations, or other similar positions).
Knowledge of government programs – familiarity with CMS regulations and NYS regulations.
Knowledge of Federal and NYS regulations and underwriting policies and all process flows.
A minimum of two years of Medicare‑specific experience is required.
Must be self‑motivated and a team player.
Physical Requirements
Must be able to travel independently between the health plan regions.
Benefits
Dental insurance
Paid holidays
Retirement plan
Remote work opportunities (case‑by‑case)
Compensation Minimum: $21.83/hr - Maximum: $34.92/hr
The salary range indicated in this posting represents the minimum and maximum for this position. Actual salary will vary depending on factors including budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.
Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
ADA Statement In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
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Responsibilities All Levels:
Level I:
Researches, interprets and responds to inquiries from internal and external customers, business partners, brokers, and consultants concerning our products, services and policies in accordance with CMS, Corporate Service strategy and other legislative requirements.
Identifies and responds to issues as brought forward either internally or externally and ensures all inquiries will be responded to within 24 hours and are most often resolved.
Attends provided or necessary training to support the job role/function and attends and facilitates meetings as necessary.
Responds to sales team requests for assistance and provides support where needed regarding new and existing business activity. Assures that all account data is maintained on a timely and accurate basis such as initial account setup, benefit books, contracts, etc.
Acts as the go‑to person to coordinate daily activities when necessary and assists with difficult issues that may surface within a day.
Assists in the maintenance of files, records, and operating manuals and provides assistance in obtaining reports as requested.
Attends meetings and/or trainings as a representative of the Medicare Sales or Enrollment Team and shares the information learned with the team.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct and the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Level II:
Assists with on‑the‑job training of other Account Service and Sales Associates as requested.
Mentors and trains other account service team members to initiate resolution of all outstanding and/or difficult issues.
Acts as a backup to the Account Executive when the individual is out of the office.
Identifies issues, patterns and/or trends generated by external and internal action affecting customer satisfaction and consistently and independently recommends and initiates changes and improvements as a result of process review.
Reviews all broker/sales‑facing documents and validates them for accuracy, including collateral for broker/sales events.
Takes the lead position in facilitating department‑wide purchase order requisitions.
Qualifications All Levels:
Level I:
Associate degree in a related field; in lieu of a degree, require three years of related experience.
Thorough knowledge and expertise of benefit programs for all health plan business required within six months of employment.
Sales and strong communication skills.
Must have experience working with the senior population.
Demonstrates expertise in problem‑solving skills necessary to accurately and efficiently resolve customer inquiries in an organized manner, resulting in superior accuracy and production levels and retention of subscriber contracts.
Demonstrated sensitivity to interacting and communicating with the Medicare‑eligible market.
Demonstrates knowledge of operating systems, spreadsheet and word‑processing applications, database functions, and any sales‑force automation software applications.
Valid NYS Life, Accident and Health license within six months of employment required.
Complete required Medicare training per CMS within six months of employment.
Level II:
A minimum of two years of experience in an equivalent sales or sales‑operation function is required (e.g., Account Service Consultant, Inside/Field Sales, Medicare Operations, or other similar positions).
Knowledge of government programs – familiarity with CMS regulations and NYS regulations.
Knowledge of Federal and NYS regulations and underwriting policies and all process flows.
A minimum of two years of Medicare‑specific experience is required.
Must be self‑motivated and a team player.
Physical Requirements
Must be able to travel independently between the health plan regions.
Benefits
Dental insurance
Paid holidays
Retirement plan
Remote work opportunities (case‑by‑case)
Compensation Minimum: $21.83/hr - Maximum: $34.92/hr
The salary range indicated in this posting represents the minimum and maximum for this position. Actual salary will vary depending on factors including budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.
Equal Opportunity All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
ADA Statement In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
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