- Consult with clients to ensure they are informed regarding PacificSource products, administrative procedures, and legislative and compliance requirements.
- Serve as a subject matter expert for benefits, compliance, and plan information. Communicate with clients, providers, PacificSource departments, and the Regional Manager to assure clear communication between all constituents.
- Attend internal and external meetings as required.
- Work to identify potential issues and seek resolution(s).
- Liaison to outside vendors which provide services/products to our clients, including but not limited to PPO networks, Pharmacy Benefit Managers, disease management programs, and other ancillary programs.
- Work with clients and consultants to develop the strategic direction of the clients’ employee benefit plans. Create and help execute a roadmap to accomplish clients’ goals.
- Present and review client reporting package, identify trends, tools, and proposed course of action to help meet client goals
- Review plan documents before delivery to ensure accuracy. Deliver and review the plan administrator manual, contract documents, amendments, benefit books, billing procedures, and other group information.
- Follow up with consultant/brokers on renewal status, renewals rates, develop alternate or optional benefit quotes, as appropriate.
- Determine reasons for client terminations and record information for team/executive review
- Negotiate with consultants/brokers and group in order to renew accounts and maintain financials.
- Participate in client group enrollment/employee benefit meetings, wellness/health fairs.
- Prepare materials and presentations for meetings, with the assistance of the Client Service Representative. Conduct/participate in new group enrollment and orientation meetings.
- Receive, analyze, and respond to client issues and assure timely, appropriate follow-up.
- Serve as client contact and problem solver for a wide range of contract issues relating to medical, dental, pharmacy, and optional benefits;, supply requests; problem resolution; and claims issues.
- Identify new selling opportunities for products sold or represented by PacificSource.
- Represent PacificSource at community events and functions.
- As requested, participate in and lead company benefit training programs.
- Meet department and company performance and attendance expectations.
- Perform other duties as assigned.
Work Experience: Minimum of five years of related experience in the health insurance industry. Must have a thorough understanding of services and products, administrative procedures, government compliance, and the health insurance industry.
Education, Certificates, Licenses: BS in Business Administration or related field; or equivalent combination of education and experience is preferred. Current Life and Health Insurance License (or eligible to earn license)