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Service Consultant in Southfield, MI at AF Group

Date Posted: 3/8/2018

Job Snapshot

Job Description



Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.


  • Handle escalated servicing issues by way of group decision makers, agents or third-party administrators.
  • Ability to work with external parties directly, such as providers and members, to resolve problems and effectively communicate findings.
  • Resolve member issues that have not previously been fixed through MA Servicing.
  • Work cross departmentally to address enrollment, claims, benefit, eligibility, and billing matters.
  • Order member specific material and process ID card requests.
  • Process member and group changes and pull membership reports.
  • Review member materials for renewals.
  • Handle issues with members prescription drug coverage in conjunction with the Pharmacy team.
  • Assist the MA Sales Consultants with inquiries and special projects.
  • Maintain confidentiality of all information processed.
  • Assist and support in the planning, coordinating, developing and implementing of approved projects which are Divisional and/or Corporate in scope to enhance the overall efficiency of operational procedures, methods, controls, and performance.
  • Analyze, process and/or expedite operational transactions; this may include timely resolution of problems.
  • Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
  • Provide leadership team with status of projects; issue, communicate and recommend policy decisions to achieve project objectives.
  • Utilize and maintain available corporate production and reporting systems; produce routine and non-routine reports, presentations, letters communications and graphics.
  • Assist personnel (both internal and external) by answering questions, supplying information and training.
  • Represent department and division as requested on work groups and special assignments.
  • Develop and maintain an effective working relationship with customers or partners.

    This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.



    Bachelor's degree in related field. Combinations of relevant education and experience may be considered in lieu of a degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.


    Two years of experience in related field required. Knowledge of health insurance industry and/or managed health care field preferred.


  • Excellent analytical, organizational, planning, and follow-up skills.
  • Ability to develop and manage projects across multiple departments including the ability to develop consensus and manage projects through collaboration and effective relationships.
  • Independent logical, analytical thinking to define problems, collect data, draw valid conclusions and take appropriate action.
  • Ability to work collaboratively in a team environment, including remotely,
  • Excellent verbal and written skills, including expertise in writing for digital and social media and video,
  • Ability to exercise independent judgment, meet deadlines and deliver on projects while working under limited supervision.
  • Ability to comprehend complex company documents, procedures and policies, and distill these into easy to understand language that supports corporate strategy.
  • Ability to speak effectively before external and internal groups.
  • Proficient in current industry standard PC applications and systems including Microsoft Office.
  • Ability to work in a team setting and independently, and under tight deadlines.
  • Ability to build trust and relationships with internal and external customers.
  • Ability to maintain confidentiality.
  • Ability to work with a variety of variables where limited standardization exists.
  • Resourceful problem solver with ability to formulate and execute plans efficiently and effectively.


    Work is performed in an office setting with no unusual hazards. Local travel is required; national travel may be required.

    The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

    We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

    Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled