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Health Plan Specialist

2 months ago


Pearl City, United States HMSA Full time

  1. CUSTOMER EXPERIENCE

    • Provide all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence.
    • Build enduring relationships with HMSA's customers/members and other consumers by becoming their personal trusted advisor, and by effectively delivering on commitments.
    • Understand the full suite of products and services offered. Seek to understand the customer's needs; analyze and identify the root causes; propose solutions that meet the customer's specific needs, issues, and problems. Gain acceptance to proceed with an option or solution. Resolve customer issues and/or close sales opportunities.
    • Use every customer interaction to move the customer along the health continuum in furtherance of HMSA's vision.
    • Analyze new customer's needs. Conduct product comparisons to determine eligibility, and identify the best product solutions, including benefits, features, company services, and operation processes and how they specifically benefit the customer. Effectively communicate, educate and sell these options to the customer.
    • Create a friendly service experience for anyone with questions regarding health care, health insurance (benefits, claims, premiums, payments and enrollment) or other related topics. Use broad product and service knowledge to educate and answer customer questions in a way that is simple and easy to understand.
    • Use web-based tools and other aids to educate customers on how to effectively use HMSA resources, including healthcare and cost information tools.
    • Using language that is customer friendly, provide guidance and education to customers/members and other consumers on changes in the healthcare industry (e.g. ACA) and how it affects them.
    • Support and deliver on the HMSA Center's overall sales, service, membership, and customer-satisfaction goals.
    • Ensure customers understand their current products, benefits, tools and how to use them effectively.
    • Service phone inquiries as needed.
    • Ensure the cleanliness and professional appearance of the common areas in the HMSA Center
    • Refill and stock collateral
    • Refill and stock refreshment station
  2. GREETING
    • Create a warm and welcoming atmosphere for HMSA Center customers
    • Warmly greet customers entering and the HMSA Center and thank them as they leave
    • Ask questions to uncover the customer's problem
    • Identify and confirm understanding of the problem
    • Assess the problem and resolve if possible.
    • As the single point person, use good judgment to guide the customer, throughout the HMSA Center experience and create an exceptional warm referral experience to management or to a subject matter expert when appropriate.
  3. TRAINING
    • Meet ongoing training requirements and keep current on product and service knowledge.
    • Understand the drivers and trends within HMSA and the healthcare industry that affect HMSA's consumers and shape their buying decisions. Be aware of competitive activities and opportunities.
    • Assist and train customers on use of the self-service tools available such as the self-service kiosk or self-service payment center
  4. STANDARDS AND COMPLIANCE
    • Comply with operational (e.g. operational playbook); service standards (e.g. consumer experience); and all federal, state, and HMSA compliance requirements.
    • Provide input and feedback on corporate policies, processes and procedures, marketing collateral and campaigns to HMSA Center Manager.

  5. Performs all other miscellaneous responsibilities and duties as assigned or directed.