Medicare Claim Representative Jobs (NOW HIRING)

Overview

We are seeking a remote Medicare Sales Account Representative/Executive for our Abilis Health Plan who will work with senior care partners to assist in enrolling new residents and members.  You will actively market our plan to new senior care partners within several of our plan service areas.  Regional travel in Kentucky and/or Tennessee is required.

We value candidates with healthcare direct sales and/or account management experience, a KY or TN State Insurance License (or willingness to quickly get one), and experience working with our elder community.  

Our base salary includes eligibility for a lucrative incentive bonus plan - paid monthly!

Our comprehensive benefit package includes:

• Competitive compensation
• Weekday and daytime shifts only
• Mileage reimbursement/Rental car availability
• Employee referral program
• Professional licensure reimbursement
• Tuition reimbursement on specific programs
• Paid time off
• 401(k) retirement savings plan
• Medical, dental and vision
• Life insurance
• Flexible Spending Account (FSA)
• Employee discounts

Responsibilities

• Working with senior care partners to assist with enrolling new resident members and discussing plan benefits with senior care partners, potential plan members and their families.
• Responsible for educating members on the plan and providing high quality customer service, providing professional, accurate and timely response to all inquiries regarding eligibility, plan coverage, coordination of benefits and claim payment solutions.
• Assisting with resolution to Member and Provider issues. Refer all unresolved issues to the next level including grievance and appeals.
• Actively market plan to new senior care partners within plan Service Area.
• Assist with identifying key providers in market area that would enhance plan’s network.
• Meet the physical and sensory requirements stated below and be able to work in the described environment.
• Responsible for year-round enrollment of eligible individuals into Signature Advantage’s Institutional Special Needs Plan(s).
• Manage market territory with plan service area.
• Meeting New and existing members to collect information on early interventions for service or health needs and communicate this back to the Care Team.
• Deliver approved sales and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and standards.
• Conduct individual meetings, small group presentations and attend scheduled facility rollout meetings as needed.
• Must communicate effectively with Medicare beneficiaries, their families, caretakers, nursing facility management and staff.
• Must consistently achieve established sales goals and report all sales and field marketing results daily.
• Responsible for tracking and maintaining accurate records in compliance with HIPAA / HITECH laws and Signature Advantage policies and procedures.
• Other special projects and duties, as assigned.

Qualifications

• Two-year associate/technical degree, bachelor’s degree or experience with direct sales and account
  management preferred.
• Tennessee/Kentucky State Health Insurance License required.
• Experience working with the senior population preferred.
• Ability to organize and manage multiple priorities is necessary.
• Must be self-directed, highly motivated and possess excellent interpersonal communication skills.
• Ability to prospect, set-up, present, close and utilize time for maximum results.
• Problem analysis and problem resolution.
• Ability to work independently with minimal direct supervision.
• Must have reliable transportation and be able to pass a background check.
• Regional travel is expected.
• Effective verbal and written English communication skills.
• Demonstrated intermediate to advanced skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation.
• Highest level of professionalism with the ability to maintain confidentiality.
• Ability to communicate at all levels of organization and work well within a team environment in support of company objectives.
• Customer service oriented with the ability to work well under pressure.
• Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity.
• Strong analytical and problem-solving skills.
• Ability to work with minimal supervision, take initiative and make independent decisions.
• Ability to deal with new tasks without the benefit of written procedures.
• Approachable, flexible and adaptable to change.
• Function independently, and have flexibility, personal integrity, and the ability to work effectively with
  stakeholders and vendors.