Medicare Sales Representative

• Implement new groups, renewals, and conversions to new product lines.
• Research, interpret, and respond to inquiries regarding products, services, policies, and procedures from internal and external stakeholders.
• Resolve customer and broker issues by coordinating with Operations, Enrollment, Billing, Customer Care, Claims, Clinical Operations, Medical Affairs, Finance, Underwriting, and other business partners.
• Respond to inquiries in a professional, efficient, and timely manner, preferably within the same business day and no later than 24–48 hours.
• Maintain accurate account records, including account setup, benefit summaries, contracts, and related documentation.
• Partner with Project Management to support vendor relationships and electronic enrollment processes.
• Utilize standard and customized products and workflows to meet client needs.
• Validate group setup and renewal completion activities.
• Complete all required job-related training and maintain compliance with applicable regulations and company policies.
• Protect member privacy and comply with all privacy, confidentiality, and data protection requirements.
• Demonstrate flexibility, accountability, and a commitment to resolving customer issues.
• Assist with training and onboarding of team members and provide support for complex service issues.
• Participate in meetings, training sessions, and professional development activities.
• Identify process improvement opportunities and recommend enhancements that support customer satisfaction.
• Represent the Account Service team during meetings and communicate key information to colleagues.
• Manage HIPAA-related requests, including Designated Record Set (DRS) requests, and serve as a resource for complex compliance-related matters.
• Support management with advanced problem-solving assignments.
• Partner with Sales to create and deliver presentations to external clients.
• Mentor and train junior team members.
• Serve as backup support for Account Managers as needed.
• Travel within the service region to support employer groups, brokers, open enrollment events, training sessions, and off-site meetings.

• High School Diploma or equivalent required.
• Associate Degree in a related field preferred.
• In lieu of a degree, two years of experience in customer service, insurance, healthcare, or a related industry may be considered.

• Two or more years of experience in a sales operations environment preferred for Level II responsibilities.
• Five or more years of experience in a sales operations environment preferred for Level III responsibilities.
• Experience supporting brokers, employer groups, customer service operations, or insurance administration preferred.
• Experience creating and delivering client presentations preferred for advanced-level responsibilities.

• Valid New York State Life, Accident, and Health License.
• Strong customer service and relationship management skills.
• Excellent verbal and written communication skills.
• Strong organizational skills with the ability to prioritize multiple tasks in a fast-paced environment.
• Ability to work independently and collaboratively while managing competing priorities.
• Proficiency with Microsoft Office applications, including spreadsheet and word processing software.
• Experience using databases and sales force automation tools.
• Ability to complete required Medicare training within one year of employment.
• Knowledge of HIPAA regulations and privacy requirements.
• Ability to analyze issues, coordinate resolutions, and follow through on commitments.
• Ability to work while sitting or standing at a workstation for extended periods using a computer, phone, keyboard, and mouse.

• Knowledge of New York State and Federal insurance regulations.
• Familiarity with underwriting policies and related processes.
• Strong relationship-building and stakeholder management capabilities.
• Process improvement and problem-solving skills.
• Experience mentoring, training, or coaching team members.
• Advanced analytical and troubleshooting skills.
• Experience supporting electronic enrollment methods and vendor relationships.
• Experience working with group insurance products, renewals, and account administration.

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