Sales Representative II - All Boroughs

Job Description

Job Description

MetroPlus Health is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

The Sales Representative II is responsible for educating and assisting qualified individuals with purchasing affordable health insurance coverage and / or obtaining an eligibility determination for coverage in Qualified Health Plans (QHPs) and insurance affordability programs such as Medicaid and Child Health Plus (CHP) through the NY State of Health (MarketPlace). The Sales Representative II is responsible for identifying and educating prospective members that do not have health insurance and / or are looking to change coverage as well as assisting existing members with recertification and education of benefits. The Sales Representative II is tasked with performing all duties in accordance with the Affordable Care Act (ACA) as well as all other pertinent rules and regulations.

Scope of Role & Responsibilities

Educational / Enrollment Process

• Educate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus.
• Assist consumers / applicants with calling the NY State of Health Customer Services Department for assistance with enrolling and / or providing verification documentation.
• Conduct public education activities for consumers to raise awareness of available QHPs within the Marketplace.
• Explain potential eligibility for public / governmental programs, how the federal health insurance premium tax credit and cost-sharing reductions work, and outline potential risk factor, if any, to consumers.
• Describe the features and benefits of health insurance coverage, including cost-sharing mechanisms like deductibles, co-pays, co-insurance and how these work and / or affect the consumer.
• Describe the different metal tiers within the Marketplace and how the benefits may change at different tiers based on the consumer's income.
• Conduct presentations and participate in ACA forums and workshops upon request.
• Assist consumers with submitting documents and information as required by the Marketplace via scan, fax, or mail.
• Assist existing members with recertification, when applicable.
• Assist consumers with the submission of premium payments when required.

Regulatory / Compliance

Tactical

Required Education, Training & Professional Experience

Licensure and / or Certification Required

Professional Competencies