Medicare Sales Representative II
5 days ago
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that healthcare is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About MetroPlusHealthMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products, including New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists, and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Job OverviewThe Sales Representative II is responsible for educating and assisting qualified individuals with purchasing affordable health insurance coverage and/or obtaining an eligibility determination for coverage in Qualified Health Plans (QHPs) and insurance affordability programs such as Medicaid and Child Health Plus (CHP) through the NY State of Health (MarketPlace). The Sales Representative II is responsible for identifying and educating prospective members that do not have health insurance and/or are looking to change coverage as well as assisting existing members with recertification and education of benefits. The Sales Representative II is tasked with performing all duties in accordance with the Affordable Care Act (ACA) as well as all other pertinent rules and regulations.
Key Responsibilities- Educate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus.
- Assist consumers/applicants with calling the NY State of Health Customer Services Department for assistance with enrolling and/or providing verification documentation.
- Conduct public education activities for consumers to raise awareness of available QHPs within the Marketplace.
- Explain potential eligibility for public/governmental programs, how the federal health insurance premium tax credit and cost-sharing reductions work, and outline potential risk factor, if any, to consumers.
- Describe the features and benefits of health insurance coverage, including cost-sharing mechanisms like deductibles, co-pays, co-insurance, and how these work and/or affect the consumer.
- Describe the different metal tiers within the Marketplace and how the benefits may change at different tiers based on the consumer's income.
- Conduct presentations and participate in ACA forums and workshops upon request.
- Assist consumers with submitting documents and information as required by the Marketplace via scan, fax, or mail.
- Assist existing members with recertification, when applicable.
- Assist consumers with the submission of premium payments when required.
- Must have a High School Diploma or GED.
- 3-5 years of Sales/Customer Relations experience required.
- Public Speaking experience.
- Must be in compliance with all conflict-of-interest standards and regulations.
- Required to work evenings and weekends.
- Must possess a valid NYS Life, Accident, and Health License at the time of employment. License must remain valid at all times during employment with no lapse in coverage. Must maintain all required continuing education requirements and renew license in advance of its expiration.
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
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