Account Services Representative

Account Service Consultant

Summary: The Account Service Consultant ensures prompt, accurate, and efficient servicing of all Broker, Member, and Employer Group Administrator inquiries. Inquiries may be via telephone, email, written inquiries, and lobby walk-in's or through on-site visits with an employer group and/or broker. This role provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance Group & Broker satisfaction/retention. The Account Service Consultant maintains constant communication with the Sales staff and other Business Partners throughout the organization.

Essential Responsibilities/Accountabilities: All Levels:

• Responsible for the implementation of new groups, renewals, and conversion of groups to new product lines.
• Researches, interprets, and responds to inquiries from internal and external customers, business partners, brokers, consultants, and groups concerning our products, services, and policies in accordance with MTM, Corporate Service strategy, NCQA, and legislative requirements.
• Identifies and responds to issues brought forward either internally or externally and ensures all inquiries will be responded to within 24-48 hours same business day preferred where possible. Interacts with Operations, Enrollment and Billing, Customer Care, Claims, Advocacy, Clinical Operations, Medical Affairs and Finance/Underwriting Departments to resolve identified issues.
• Assures that all account data is maintained on a timely and accurate basis such as initial account setup, benefit books, summaries, contracts, etc.
• Partners with Project Management team to support vendor relationships and conversations related to electronic enrollment methods for assigned book of business.
• Utilizes both standard and custom products in a manual workflow to meet the needs of external clients.
• Validates all group set up and renewal completions.
• Completes and successfully passes training(s) to support job role/function.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Demonstrates willingness to adapt and be flexible to changes and business needs while taking ownership and accountability for issue identification and resolution.

Level II (in addition to Level I responsibilities/accountabilities):

• Assists with on-the-job training of other Account Service and Sales Account Managers as requested. Support Level I team members with more complex issues.
• Ongoing participation in meetings, training, and skill development to support career path and individual development plans.
• Identifies issues, patterns and/or trends generated by external and internal action affecting customer satisfaction and consistently and independently recommends and initiates changes and improvement for process review.
• Attends meetings and/or trainings as a representative of the Account Service Team and shares the information learned with the Account Service Staff within a reasonable timeframe.
• Handles HIPAA (Health Information Portability and Accountability Act) issues as requested by members through Group Administrators. Specifically, handles all Designated Record Set (DRS) requests and may serve as a point person for the Account Service team when difficulties arise in obtaining information through normal channels.

Level III (in addition to Level II responsibilities/accountabilities):

• Assists with tasks assigned by management that require advanced problem-solving skills.
• Partners with Sales to create and deliver presentations to external customers.
• Mentors and trains more junior Account Service team members to initiate resolution to all outstanding and/or difficult issues.
• Acts as a back up to Account Manager when individual is out of the office.

Manager's words:

-Broker support for direct pay Medicare brokers Answering phone calls Helping run/manage reports Benefit inquiries Responding to emails -50-100 calls/day -3 broker support lines to manager rolling phone tree 4 other staff members that will be on phone lines -Help as needed with other tasks

Skills: health insurance, account management, customer service, benefits administration, benefits management

Top Skills Details: health insurance

Additional Skills & Qualifications:

All Levels:

• High School diploma or equivalent required. Associates Degree in related field preferred. In lieu of degree, 2 years of experience in service or healthcare industries.
• Valid NYS Life, Accident and Health license within six months of employment required.
• Familiarity with NYS and Federal regulations and underwriting policies a plus.
• Strong oral/written communication and customer service skills.
• Strong organizational skills and ability to prioritize, multitask, and work in fast paced environment and remain professional and focused under multiple pressures and demands.
• Ability to complete required internal Medicare Training per Center for Medicare Services within one year of start date.
• PC skills essential: spreadsheet and word processing applications, database functions and sales force automation software applications.

Level II (in addition to Level I):

• Two or more years of experience in a sales operations environment.
• Valid NYS Life, Accident and Health license.
• Knowledge of NYS and Federal regulations and underwriting policies and all process flows.
• Demonstrated relationship building skills.

Level III (in addition to Level II):

• Five or more years of experience in a sales operations environment.
• Valid NYS Life, Accident and Health license.
• Proficient with NYS and Federal regulations and underwriting policies and all process flows.
• Experience creating and delivering client presentations.
• Excellent analytical/problem-solving skills.
• Ability to travel within the Health Plan service region as necessary to offer support for on-site visits to groups/brokers, open enrollments, training, and/or off-site meetings.

Experience Level: Intermediate Level

Job Type & Location: This is a Contract position based out of Rochester, NY.

Pay and Benefits: The pay range for this position is $22.00 - $24.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type: This is a fully remote position.

Application Deadline: This position is anticipated to close on Aug 11, 2026.