Operations Sales Specialist

Avera Health Plans

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$22.00 - $29.50

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview
Responsible for the in-house serving of our consumer solutions customers and their agents or partners. The Operations Sales Specialist will provide customer service to Avera Health Plans members and their agents by answering questions about Avera Health Plans consumer sales products and services. The Operation Sales Specialist will support onboarding, implementation, agent education, trainings and marketing campaigns.
What you will do

• Provide exceptional customer service to members, agents, and partners. Answer questions, investigate issues, and solve problems in an efficient and responsive fashion. Customer service is provided via web solutions, in person consultations, telephonic/electronic communication support.
• Provides accurate and consistent communication of Avera Health Plans policy and procedures to members and agents.
• Facilitate and support member eligibility and termination processes for Avera Health Plans functional areas, delegate vendors and agents.
• Build strong professional relationships with agents.
• Provide support for other departments with questions, mailings, proofing, and call coverage.
• Demonstrate knowledge of plans and products, the benefit structure of each, and identify ways to effectively communicate and educate benefits to members, agents, and partners.
• Determine benefit eligibility for members assigned by policy. Research claim and benefit inquiry, evaluate if claims need to be reprocessed and complete necessary documentation to request an adjustment on behalf of members.
• Consistently document and report all calls and issues initiated and/or addressed within the Sales Department. Support the Sales Customer Call Center by providing support to new members transitioning to Avera Health Plans and providing support for current members with inquiry on plan options and renewal dates during the renewal process.
• Counsel prospective members on consumer-based plans and product options and support marketing campaigns for each consumer sales solution.

Essential Qualifications
The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
Required Education, License/Certification, or Work Experience:

• High School or GED Equivalent

Preferred Education, License/Certification, or Work Experience:

• Familiarity with medical terminology and medical insurance billing.
• Call center environment.

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO available day 1 for eligible hires.

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to [email protected].