Support Specialist-Individual Health Insurance

Position Description:

The Support Specialist for Individual Health Insurance is responsible for comprehensive application processing, agent support, issue resolution, and customer service functions across health, dental, and vision products. The position manages submissions, corrections, marketplace assistance, and carrier communications while ensuring accurate documentation within Salesforce. The specialist also collaborates closely with the Individual Health Broker Manager to support administrative, compliance, and broker‑engagement initiatives. 

Primary Responsibilities & Essential Functions:

Application Processing:

• Review, validate, and process incoming Individual Health product applications submitted via email, phone, fax, or electronic platforms.
• Ensure all applications meet CMS, state, and carrier compliance requirements.
• Classify and track applications by carrier, product type, and broker.

Broker Support:

• Serve as a primary point of contact for brokers needing forms, application assistance, or status updates.
• Provide carrier approved enrollment documents, instructions, and policy numbers once issued.
• Respond to broker inquiries promptly and professionally.
• Assist Brokers with information and processing of auto-draft changes, Agent of Record submissions, cancellations, Carrier Microsite set up, and other service issues. 

Support for Individual Health Broker Manager:

• Assist the Individual Health Broker Manager with administrative tasks related to broker operations.
• Support special projects, broker onboarding, communication efforts, and compliance tracking.
• Contribute to initiatives that enhance broker engagement and performance reporting.

Salesforce Data Entry & Record Management:

• Accurately enter and update member records, broker information, and application statuses in Salesforce.
• Upload documentation such as applications, SOAs, and correspondence.
• Log tasks, interactions, and policy confirmations within CRM workflows.

Skills & Abilities: 

• Strong attention to detail and accuracy in data entry and documentation.
• Ability to interpret and follow CMS and carrier guidelines.
• Excellent written and verbal communication skills.
• Strong organizational and time management abilities.
• Ability to manage multiple tasks and deadlines in a fast paced environment.
• Customer service mindset with a professional and supportive approach.
• Proficiency with CRM systems (Salesforce preferred).
• Ability to work independently while collaborating effectively with remote teams.
• Being Bilingual is highly desirable (particularly Spanish)
• Expected to maintain confidentiality and adhere to HIPAA, CMS, and organizational compliance standards.

Education & Experience:

• Prior experience in insurance processing, healthcare administration, or Medicare/Individual Health enrollment is highly desirable.
• Experience working with brokers or in a support oriented operational role is a plus.
• Familiarity with CRM platforms, especially Salesforce, is preferred.

Working Conditions:

• In-Person or Hybrid work environment with required access to secure systems and communication tools.
• May require extended hours during peak enrollment periods (primarily the fall open enrollment season).

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