A Benefits Consultant (BC) interfaces with a group of clients (a book of business) to strategize and propose viable solutions to manage the menu of benefit options that the client offers to its employees. BCs partner with clients and assist them with 1) emerging trends in employee benefits, 2) their annual renewal process, and 3) other possible options that would enhance or meet the goals of the client; the end product of this partnership is intended to add value to the client, enabling the client to be competitive in their own industry. BCs quickly assess the nature of any given problem, understand thoroughly the expectations of the client, and consistently meet or exceed those expectations. The Small Business Consultant’s role must also address all employee benefit issues as brought up by Company’s clients and their employees, including resolving enrollment and termination issues, acting as liaison with insurance carriers, and answering questions relating to pertinent federal and state legislation. In addition, the Benefit Consultant is responsible for shopping the market, preparing proposals for renewal, and Consulting via telephone for designated clients. BCs regularly practice discretionary decision making on a daily basis.
1. Consulting (30%)
Understands key business issues facing the client and the role employee benefits play in their business. Helps client articulate their long term employee/benefit goals and develop a strategic plan to achieve them. Becomes a trusted advisor with each client. Acts intentionally to retain clients and succeeds according to performance standards.
Understands thoroughly and stays abreast of changes in employee benefits, including plan designs, available riders, legislation, and emerging trends.
Strategically plans and executes plan renewals, staying in regular communication with the clients and updating them on various emerging trends and solutions for their business needs. Anticipates concerns developing from the renewal process.
Prepares for client meeting (phone) by developing a strategy based on planning meeting, timeline and prior visits. Understands how information may/may not impact the client.
Conducts client presentations in a consultative (logical, professional and informative) manner. Assesses client/audience’s understanding and attitude during meetings and presentations and adjusts accordingly. Encourages feedback from the client. Projects confidence, not arrogance.
Conducts all Consulting duties via telephone. (Exceptions only as approved by manager.)
Strives for 100% client retention.
Addresses issues and problems directly. Acknowledges responsibility for errors and strives to make amends and repair relationship.
Develops a friendly and personal, yet professional, relationship with the client.
Becomes a valued advisor and trusted advocate.
Provides an optimistic viewpoint during difficult times.
Provides accurate and timely client deliverables according to Performance Standards.
Reviews all presentation material thoroughly well in advance of meeting and checks to ensure there are no errors and that content is pertinent and practical. Ensures that follow up issues are handled timely and communicated to client.
2. Service (35%)
Effectively addresses client problems and issues. Assesses the nature of a problem quickly, understands thoroughly the expectations of the client, consistently meets those expectations through viable solutions, and does so in a timely manner. Acts proactively when a potential problem is discovered.
Acts as a liaison with insurance carriers, providers, and clients to resolve claims (including assistance in the appeals process), enrollment, termination, and billing issues.
Provides knowledgeable answers regarding policy coverage information (ex: RX, Covered procedures, Pre-Ex limitations, etc.), in addition to legislation and benefit laws such as HIPAA, COBRA, FMLA, Michelle’s Law, Mental Parity & Medicare Part D, etc.
Maintains a full book of business while continuing to provide A+ service, in addition, to receiving positive feedback on Client Surveys.
3. Administration (35%)
Uses Benefit Point to document and assign all client service issues. Also uses Benefit Point to document key steps in the renewal process as outlined in Performance Standards and attaches all required elements to AW client record.
Ensures that the implementation and transition processes for all carrier changes are handled smoothly with minimal disruption. Communicates and documents major issues and changes. Stays on top on “next steps”. Ensures that submission and all applicable documents are processed accurately and timely.
Proactively checks and verifies all information (new rates, employee enrollments and changes, ID cards, etc.). Promptly addresses and solves problems generated through the renewal process.
Is prepared, organized, and methodical. Has a system for tracking and managing the various issues and projects that are in process.
Completes required forms timely, including but not limited to Production Report, Expense Report, Cross Sell Form, etc. Provides completed Activity Log to manager by 5th of month.
Process service cases, value added, and workflow terminations in Benefit Point according to the provided guidelines and in coordination with the Quality Assurance Program.
Update all renewal outcomes in Benefit Point including any changes to the main business screen and all policy lines. In addition, handles scanning necessary documentation such as plan documents, certificates of coverage, etc.
Tracking renewal dates and sending 125 day advance renewal notification letters to clients and updating Benefit Point with all stages of timeline
Following up with clients to obtain updated census information & Medical Information on groups that require a RAQ to be completed; preparation of specific carrier RAQ’s for client
Sending, tracking, and following up on carrier quotes (online or RFP) for medical and ancillary lines of coverage as well as updating stages in Benefit Point.
Preparing spreadsheets to display and communicate carrier information for presentation to client.
Process all incoming enrollments, terminations, change forms (including COBRA), and submissions and forward to appropriate carrier for processing utilizing online capabilities when possible.
Process all carrier submissions.
Contacting the client for additional information.
Follow up with the carrier for final results.
Communicate any rate ups to the Client.
Process all carrier confirmation letters to the clients.
Process all carrier termination letters (sample letter to client & send to carrier).
Update AgencyWare and scanning on all member enrollments, terminations, change forms (including COBRA forms) and requests for additional information for submission completion. The ISRs will remain responsible for updating final plan or carrier changes in AW.
Provide all Welcome Letters to new clients.
Successful electronic processing will require A+ accuracy, focus and a great attention to detail and execution.
Reports to: Director of Benefit Services
Significant insurance experience required; at least 3 years of work experience (claims resolution, benefits administration, employee benefit customer service, etc.).
High school diploma and Louisiana life and health license minimally. College degree preferred.
Continuous education encouraged (industry coursework leading to producer’s license or professional designation).
Excellent problem solving skills. Persistent to achieve the end result—resolution.
Strong organizational skills, including daily prioritizing and logical thinking.
Service-oriented; kind, compassionate, and willing to work hard on another person’s behalf.
Good communication skills, especially verbally and over the phone. Clarity and accuracy are key.
Excellent phone skills, being responsive, empathetic, and honest with the information to be shared.
Strong working knowledge of computers (MS Word, MS Excel MS Outlook preferred; Internet, and database experience also beneficial) and able to learn new systems and programs, such as Benefit Point.
Able to manage multiple projects simultaneously and successfully.
Able to work with others in teams; able to work with those who perform similar jobs as well as complimentary roles. Promotes cooperation and shared successes throughout the company.
Shares ideas for improvement that are oriented around solutions and blameless problem solving.
There are no physical requirements for the position.
This position description is not intended to be all-inclusive, but to provide a general scope of the person and the position, outlining the primary responsibilities, reporting structure, and knowledge/strengths/abilities required to succeed. It is not a contract.
Company is an equal opportunity and affirmative action employer that does not discriminate on the basis of race/ethnicity, national origin, religion, age, color, sex, sexual orientation, gender identity, disability or veteran's status, or any other characteristic protected by local, state or federal laws, rules or regulations.
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