Medicare Authorized Representative

Triple-S; Puerto Rico; On-site; USD 50,000 - 70,000; Full time

Job summary

Triple-S is seeking a Medicare Authorized Representative to promote our managed care products for people eligible for Medicare. You will grow membership through in-home enrollment meetings, provider education sessions, and community outreach while adhering to CMS rules and company policies.

The role emphasizes building positive provider and community relationships, timely reporting of visits and enrollment data, and accurate processing of applications to meet enrollment requirements.

Qualifications

• Bachelor's degree in Business Administration or Health-related field preferred.
• 1–3 years of related experience in health insurance preferred; 5+ years acceptable in lieu.
• DOI – Health and Disability License or ability to obtain within first 15 days of employment.
• Knowledge of CMS rules and enrollment procedures.

Responsibilities

• Promote and sell TSA products in an assigned territory.
• Maintain positive relationships with providers and community organizations.
• Submit daily in-home visits reports to Sales Coordinator.
• Report daily production to Supervisor and Manager.
• Ensure completed applications meet enrollment requirements and deadlines.
• Communicate benefits and enrollment information to potential members, including those with disabilities.
• Identify community groups to promote products and services.
• Liaise with community advocacy groups impacting the target population.

Skills

Action oriented

Collaborates

Manages ambiguity

Instills trust

Customer delight

Education

Bachelor's Degree in Business Administration

Associates Degree (60-64 credits)

Job description

At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.

When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

Let's build healthier communities together,

Job Summary

Responsible for effectively promoting our managed care products designed for persons eligible for Medicare. The Medicare Authorized Representative will grow membership through various sales and marketing initiatives, including conducting face-to-face sales enrollment meetings, communities, and providers education sessions to existing and potential members. Required to follow all company and CMS rules and regulations, and will be monitored regarding volume, quality, accuracy, and demeanor.

Essential Functions

• Responsible for managing an assigned territory to promote and sell TSA products.
• Maintain and establish positive relationships with providers and organizations in the community.
• Follow procedures and timeliness when submitting daily in-home visits reports to Sales Coordinator.
• Report daily production as agreed with Supervisor and Manager.
• Responsible for ensuring the completeness, quality and eligibility criteria of member's application to meet Enrollment Requirements.
• Contact or follow up on current members in order to obtain customer satisfaction.
• Responsible for effectively communicate benefits and enrollment information to potential members; especially those members with special needs due to physical and/and or mental disabilities.
• Ensure all completed applications are submitted within required time frames; complete administrative paperwork to maintain smooth operations and log activities.
• Identify groups, social services agencies and any other community organization to promote products and services.
• Acts as liaison with community advocacy groups that impacts our target population.

EDUCATION

• Bachelor's Degree in Business Administration

Experience

• Bachelor's degree in Business Administration and/or Health, preferable, with 1 to 3 years of related experience preferable in the Health Insurance Industry, or associates Degree (60-64 college credits) with 3 to 5 years of related experience preferable in the Health Insurance Industry.
• Or at least 5 years of this work experience in lieu of.
• DOI – Health and Disability License (or ability to request one within first 15 days of employment).

COMPETENCIES

• Action Oriented
• Collaborates
• Manages Ambiguity
• Instills Trust
• Customer Delight (Employee)

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.