We are seeking a detail-oriented and customer-focused Health Insurance Specialist to join our team. In this role, you will assist clients with selecting the right health insurance plans, managing claims, and ensuring that they understand their coverage options. You will play an essential part in providing exceptional service, explaining policies, and helping clients navigate the health insurance process.

Key Responsibilities:

• Client Consultation: Assist individuals, families, and businesses in selecting the best health insurance plans based on their needs, preferences, and budget.
• Plan Enrollment: Guide clients through the health insurance application and enrollment process, ensuring they meet all requirements and deadlines.
• Policy Explanation: Educate clients about the details of their insurance plans, including coverage options, costs, exclusions, and claims processes.
• Claims Processing: Review and process health insurance claims, ensuring they are submitted correctly and in a timely manner.
• Customer Support: Address client inquiries related to their policies, claims, coverage, and benefits. Resolve any issues related to billing, coverage disputes, or other concerns.
• Documentation & Record Keeping: Maintain accurate client records, policy details, and communication logs in compliance with company guidelines and regulations.
• Compliance & Regulations: Ensure all client interactions, policies, and claims are in compliance with federal, state, and local health insurance laws and regulations.
• Renewals & Updates: Assist clients with policy renewals, making necessary updates to coverage or beneficiary details.
• Claims Follow-up: Follow up on outstanding claims, working with insurance carriers and medical providers to resolve discrepancies.
• Market Knowledge: Stay up-to-date with industry trends, new health insurance plans, and changes to health care laws to provide clients with accurate and current information.

Qualifications:

• Education: Bachelor’s degree in business, health administration, insurance, or related field (preferred) or equivalent work experience.
• Experience: Experience in health insurance, customer service, or related fields is preferred.
• Licensing: Must possess or be willing to obtain required health insurance licenses (e.g., Life & Health License) as per state regulations.
• Technical Skills: Proficient in Microsoft Office Suite (Word, Excel, PowerPoint) and familiarity with insurance software or claims management systems.
• Communication Skills: Strong verbal and written communication skills with the ability to explain complex insurance concepts in simple terms.
• Attention to Detail: Ability to accurately process claims, manage client records, and handle sensitive information.
• Customer Service: Exceptional customer service skills with a friendly, professional demeanor.
• Problem-Solving: Ability to troubleshoot issues and find solutions for clients promptly.

Skills & Competencies:

• Client-Focused: Ability to build strong relationships with clients and provide personalized service.
• Analytical Thinking: Comfortable reviewing policies, claims, and medical records to resolve issues and make recommendations.
• Time Management: Ability to manage multiple tasks, meet deadlines, and work efficiently in a fast-paced environment.
• Adaptability: Ability to adjust to changes in policies, insurance laws, and company procedures.

About The Company Check

The Company Check is a leading business information provider that provides real-time data and tools that makes it easier for companies of all sizes to see the bigger picture when making sound decisions. We deliver reliable and relevant insights to improve sales efficiency within your organization, all through a single access point to our comprehensive platform.

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