Inside Sales Representative

Site: Mass General Brigham Health Plan Holding Company Inc.

Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham we are on the forefront of transformation with one of the worlds leading integrated healthcare systems. Together we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries and a benefits package with flexible work options career growth opportunities and much more.

This role will set sales appointments recruit attendance at group sales meetings respond to benefit inquiries and complete enrollment applications in a live sales queue for Mass General Brigham Health Plans Medicare prospects.

Principal Duties and Responsibilities:

-Serves as the resolution point for our Medicare Advantage members.
-Maintains all inventories and aging at or ahead of service level standards.
-Meets or exceeds productivity and quality standards for team.
-Address prospect questions including eligibility benefit interpretation and cost sharing via inbound and outbound calls walk-in contact and written correspondence/email.
-Assure understanding level of each prospect/enrollee by providing clear complete and accurate information regarding assigned product benefits policies and procedures.
-Qualify each prospect according to departmental and federal guidelines.
-Meet accessibility and quality goals such as average speed of answer and abandonment rate. Document complete and accurate prospect records and process all appointments registrations and requests for information in CRM.
-Meet individual and team membership goals.
-Follow company and federal sales and marketing guidelines in all interactions with prospects.
-Research issues delegated to them from other departments within Mass General Brigham Health Plan as well as vendors
-Resolves complex benefits claims and eligibility issues
-Identifies prospective member issues/concerns rapidly and precisely
-Research required information using available resources and triage when necessary
-Handles and resolves prospective member inquiries and complaints.
-Initiates follow up prospective member calls
-Completes call logs to record prospective member interactions and -transactions recording details of inquiries complaints and comments as well as actions taken
-Refers prospective member grievances and appeals to designated departments for further investigation
-Responsible for navigating multiple systems in order to resolve prospective member issues
-Receives and responds via email to inquiries from members and providers.
-Research prospective member concerns and take accountability through resolution
-Escalate prospective member complaints and feedback to management as required
-Achieve and maintain departmental productivity
-Completes call logs to record prospective member interactions and transactions recording details of inquiries complaints and comments as well as actions taken
-Responsible for navigating multiple systems in order to resolve prospective member issues
-Serves as a liaison between the Prospective Member Service and various departments and vendors within the organization.
-Provides feedback to leadership on trends
-Answers inbound ACD calls during periods of high call volume
-Returns after hours Voicemail Messages
-Handles incoming post mail and faxes.
-Acts as the primary representative for Mass General Brigham Health Plan for our prospective member focusing on engagement.
-Anticipates and meets or exceeds internal and/or external prospective member expectations and requirements; establishes and maintains effective relationships with prospective member and gains their trust and respect.
-Maintain Prospective member Service Behavior Competencies: Communication Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude Relationship Building/Caring and Service Excellence/Accountability/Critical Thinking
-Hold self and others accountable to meet commitments.
-Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
-Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
-Other duties as assigned with or without accommodation.

Required:

• High School diploma or GED required;
• Health Producers License
• AHIP certification (must obtain within 3 months of employment)
• 4 years in a sales or service environment
• Knowledge of the health insurance industry
• Ability to work well under pressure and in a rapidly changing environment

Preferred:

• Associates Degree or Bachelors Degree
• High school and college level courses in computers English or business helpful
• Bilingual (Spanish) or other
• 2 years in an HMO/Health Care Industry setting
• Experience in Medicare Advantage and Medicare products
• Knowledge of call center telephony and technology
• Proficiency with MS Office suite
• Understanding of Protected Health Information (PHI) and the necessity to maintain confidentiality of this information

Working Conditions:

• This role is mostly remote with roughly 2-3 meetings at the office is Assmbly Row Somerville every year
• This is a Monday through Friday role with typical hours between 8 AM and 5 PM . During April through September you will also need to work 11:30 AM-8 PM for 1-2 days/week

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Mass General Brigham Health Plan Holding Company Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework