Join to apply for the Partner Experience Representative role at Alignment Health 1 day ago Be among the first 25 applicants Join to apply for the Partner Experience Representative role at Alignment Health Get AI-powered advice on this job and more exclusive features. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Partner Experience Representative assists in the servicing of the Partner Experience Department by answering questions via phone or e-mail with a friendly demeanor, researching and resolving Agent issues as it relates to member services, benefits, commission payments, application status, and communications in general. Tracks webinar attendees, and grades exams while updating Salesforce.com with updated status. Assists Agent contracting with reconciliation of Agents status of Ready to sell based on submitted forms. General Duties/Responsibilities Answers incoming broker support queue phone calls from contracted Agents during our Hours of operation Monday through Friday. Schedule can vary from 8:00am to 6:00pm. These hours shall be defined as “Normal Business Hours”. Some weekends required. Ensures that the Partner Experience Queue meets all defined service levels and that appropriate coverage is made during break or meal periods. This position ensures that all calls are coded or “wrapped up” correctly and that proper reports are generated to ensure service levels. Codes include the following: RX issues, general benefits, application issues, payment commission issues, packet orders, trainings and tests, verification of Part A and B, verification of Medi-Cal, network lookup and provider issues. Prompts e-mail of phone follow-up as needed with established brokers to ensure satisfaction, respond to queries, solicit further sales (referrals), and solve or refer problems to appropriate internal AHP departments or external partners like Florida Blue and Humana in North Carolina. Identifies nature of broker call and refer to the appropriate department for resolution if out of basic scope of knowledge as listed above. Works to resolve situations with Member Services Department and Eligibility to triage broker issues as they relate to member. Logs calls into Salesforce.com with Date of call, Caller name, nature of the issue, and resolution status. Conducts monthly verification of Agent licensure on the DOI website to ensure that each broker that is active. Notates this in the broker file. Makes outbound calls to Brokers as necessary for reservations, confirmations, and communication regarding events as well as any other information. Coordinates the venue for FMO meeting, training, and events. Maintains the attendance RSVP list of all active brokers who attend training meetings. Creates and maintains all Sub-Agent files and Correct Certification and Re-Certification exams. Ride Along evaluations, exams and current Life licensure must be filed for each broker that participates in Salesforce.com During Annual Election Period (AEP), as well as during downtime, the broker-based responsibilities will be primary with data entry as secondary. Other duties as assigned. Experience Job Requirements: Required: Minimum One (1) year of customer service/telemarketing experience. Sales or related experience, preferably in the Medi-Cal, Commercial, or Medicare Managed Care industry. Preferred: Customer service in the Healthcare or insurance industry. Education Required: High School Diploma or GED. Preferred: College courses. Specialized Skills Required: Knowledge of Medi-Cal, Commercial, and Medicare Managed Care Plans. Solid computer skills (Word, Excel, PowerPoint, Salesforce, CRM). Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Preferred: Bilingual (English/Spanish) preferred. Licensure Required: None Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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