The Consultant serves as the primary business contact for the client and is responsible for client satisfaction. The person in this position is expected to consistently provide excellent customer service to accounts, as well as represent client needs and goals within the organization to ensure quality. In addition, the Consultant will build relationships with clients to encourage new and repeat business opportunities. The Consultant is expected to project a professional company image through all interactions with clients, insurance carriers, coworkers and others. The level of support depends on the size of client as well as complexity and revenue of the account.
- Leads client teams' projects, deadlines and meetings utilizing project management tools.
- Ensures compliance with professional standards including use of templates, client calendar and peer review process.
- Develops employee communications strategy and oversees other team members in the execution of this strategy including management of open enrollment process.
- Accountable for revenue/profitability for client accounts.
- Responsible for establishing necessary carrier/vendor relationships with appropriate contacts to serve clients in handling all administration of eligibility, claims, billing, plan implementation, contracts, plan changes and necessary amendments.
- Resolves client issues via phone or email. May delegate issue to the analyst and if the analyst cannot resolve the issue, the consultant will then contact carriers and vendors on behalf of the client.
- Works directly with the client and manages the request for proposal (RFP) process with the health insurance carriers and internal underwriter and account managers.
- Reviews the underwriter and/or account manager’s compilation of the health benefits information from a variety of sources (such as hard files, electronic files, the client and carriers), responses from the carriers and the data in a spreadsheet template (customization depends on client plan types, funding, rate structure, etc.), reviews the transparency documents (compliance documents required for completion of all health and benefits work); maintains all appropriate documents in proper files.
- Peer reviews RFP information, analyzes and interprets the results, edits and finalizes the executive summary report to be sent to the client.
- Reviews claim and utilization data from insurance carriers on a monthly/quarterly basis that has been input into a standardized report template by the underwriter and/or account manager; analyzes and interprets data for trends; peer reviews customized, client ready reports; submits report to client and replies to any questions the client may have.
- Reviews Summary Plan Description (SPD), plan documents and 5500s for compliance and compare to the benefits that were sold to the client. Ensures all benefits are accurately reflected, following a checklist to ensure that all necessary information is included where appropriate. Follows up with the carriers to make sure necessary changes are reflected.
- Generates new sales through existing clients and client referrals in accordance with the sales plan. Introduces other Relation products and services to clients.
- Gathers health and welfare benefits data from a national survey, inputs it into a template and compares the client's plan information (such as the benefits they offer, rates, and contributions) to other companies by industry or geography. The consultant is responsible for interpreting the results and presenting the information to the client.
- Other duties and projects as assigned.
- Strong analytical and mathematical skills.
- Excellent PowerPoint and presentation skills for both in-person and teleconference/webinar sessions.
- Excellent interpersonal skills; strong oral and written communication skills.
- In-depth understanding of lines of coverage for employee benefit plans: medical, dental, life, long-term disability (LTD), short-term disability (STD), accidental death and dismemberment (AD&D), vision, etc.
- Must understand R.A.F. (Risk Adjustment Factor) and the components to how rates are created, maintained and delivered on new business and renewals.
- Outstanding interpersonal and communications skills are required to maintain effective relationships with clients, co-workers, carriers, vendors and others.
- Advanced skills in Microsoft Office (primarily Excel, PowerPoint and Word). Must be computer literate with the ability to learn new software applications, such as online benefit enrollment programs and carrier enrollment sites.
- Exceptional knowledge of the rules and regulations associated with HIPAA, COBRA, Health Care Reform and all other legislation and compliance related areas to Group Health programs.
- Exceptional knowledge of insurance markets, products, services, ratings and underwriting procedures.
- Valid driver’s license,; the ability to travel to client sites and a reliable source of transportation.
- Enthusiastic, dependable, highly motivated and detail oriented.
- Hands-on, open minded, proactive team player.
- Self-managed and responsible for project and time management.
- Customer focused, high integrity, excellent work ethic.
- Excellent customer service skills are a must.
- Willingness to adhere to all principles of confidentiality.
- Must value operating in a collaborative work environment.
- Ability to work independently and as part of a team.
EDUCATION AND QUALIFICATIONS
- College degree preferred.
- 7+ years’ account management experience in the insurance industry with a focus on Accident and Health lines of coverage is required.
- A Life Accident & Health License from state of domicile is required and must be maintained.