Client Service Representative
PacificSource Health Plans - Tigard, OR

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Overview:

Secure, build, and sustain customer relationships, fostering a partnership and enhancing dialogue with clients. Act as an expert resource for the client to ensure inquiries are responded to and resolved in a timely fashion. Ensure existing clients are satisfied with and recognize the value offered by PacificSource.

Responsibilities:

  • Consult with clients to ensure they are educated on PacificSource products, administrative procedures, and legislative changes while meeting targeted goals for assigned service territory.
  • Develop positive working relationships with group administrators by serving as a first resource for benefits, compliance, and plan information. Act as a liaison between groups, producers, and PacificSource to resolve problems and comply with requests. Communicate with clients, providers, PacificSource departments, and the Regional Manager as needed.
  • Distribute and explain the Group Administrator Manual, contract, benefit book, and other products and services provided by PacificSource.
  • Participate in group enrollment/employee benefit meetings, wellness/health fairs, for PacificSource clients. Group benefit meetings include presentation of the group’s medical and optional benefits, administrative procedures, provider networks, and access to other services provided by the client’s plan benefits.
  • Receive, analyze, and respond to client issues with appropriate follow-up on specific customer requests, including administration questions, supply requests, problem resolution, and intricate claims issues.
  • Serve as client contact and problem solver for a wide scope of contract issues relating to medical, dental, pharmacy, and optional benefits offered by PacificSource.
  • Write, proof, and distribute account service reports to the producer of record.
  • Identify selling opportunities for PacificSource, Manley, and PacificSource Administrators, United Heritage and other ancillary products.
  • Represent PacificSource, both internally and externally, as required at events, including but not limited to: Forum, Underwriters State Conference, Business Expo, Chamber of Commerce, and all other community activities or volunteer opportunities.
  • As requested, participate in and lead company benefit training programs.
  • Regional office Client Service Representatives may be required to assist with clerical duties for efficient administrative office functions.
  • Perform other related duties as requested or required.

  • Qualifications:

    Work Experience: Minimum of three years related work experience in a professional environment. Health insurance or producer experience required. Solid customer service experience is required.

    Language skills: Must have excellent grammar, punctuation, spelling, composition, formatting, proofreading, and editing skills. Excellent verbal and written communication skills and the ability to communicate effectively with all types of individuals. Ability to effectively explain medical plans and administration to groups of varying educational backgrounds and familiarity with benefits. Excellent public relations skills and public speaking ability.

    Reasoning Ability: Requires the ability to define problems and draw conclusions; ability to understand organizational practices and philosophy and knowledge of business practices; ability to prioritize workload and understand and carry out written and verbal instructions.

    Mathematical Skills: Basic math skills required, including percentages and ratios, for composing graphs, creating spreadsheets, and conducting analyses.
    Education, Certificates, Licenses, Registration: Requires AA/AS in Business or related field; or equivalent combination of education and experience. BS in Business Administration or related field is preferred. Current Life and Health license (or eligible to earn license) as a Life & Health Insurance Sales Producer.

    Other Skills and Abilities: A thorough understanding of insurance products, contracts, administrative procedures, and the health insurance industry’s legal and mandatory guidelines preferred. Ability to remain current on PacificSource administrative procedures and products, healthcare, and the health insurance industry. Provide prompt, professional, and courteous service to customers, producers, and PacificSource employees. Ability to work in a fast-paced environment, managing shifting priorities and multiple tasks simultaneously. Superior work leadership skills, including taking action without specific direction. Requires a high level of integrity and trust, given frequent exposure to confidential material. Demonstrated ability to remain resilient, flexible, and focused in a changing environment. Work autonomously and independently. Maintain confidentiality and security of information. Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook. Desire to learn new things, anticipate problems, and develop contingency plans to manage them.

    PacificSource is an equal opportunity and affirmative action employer.

    PacificSource Health Plans - 22 months ago - save job - copy to clipboard
    About this company
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    PacificSource Health Plans is anything but a typical health plan. We’re a growing, independent, not-for-profit organization with a...