Broker Contract Specialist II (Remote)
Job Description
Resp & Qualifications
PURPOSE:
The Broker Contract II Specialist is responsible for providing comprehensive support and communication to Brokers, Agencies, General Producers (GPs), Full-Service Producers (FSPs), and Broker Sales staff. This role serves as a key coordinator for Individual, Group, Exchange, and Producer agreement reviews, ensuring compliance with contracting, credentialing, and regulatory requirements across MD, DC, and VA markets. The specialist reviews, analyzes, and evaluates documentation to ensure accuracy, compliance, and adherence to established policies and procedures.
ESSENTIAL FUNCTIONS:
- Review and analyze documentation submitted by Brokers, Agencies, GPs, and FSPs to determine the appropriate course of action. Ensure timely and accurate processing of credentialing, Broker of Record (BOR) transfers, Block Transfers, and Broker/Agency Agreements for Individual and Group business while maintaining compliance with departmental standards and regulatory requirements.
- Provide professional, accurate, and timely responses to inquiries from internal and external customers. Utilize independent judgment, analytical skills, and critical thinking to research and resolve broker commission withholding issues, recognizing the financial impact of processing inaccuracies. Leverage proficiency in Microsoft Office applications, including Excel, Word, Outlook, and Teams, to support reporting, communication, documentation, and data analysis activities. Prepare written correspondence related to updates and transfers and maintain adherence to departmental Standard Operating Procedures (SOPs).
- Accurately enter and maintain broker data in Facets billing system to support tracking of BOR and Block Transfer activities. Onboard brokers and agencies by entering and maintaining the Broker/Agency Agreements and credential updates in Salesforce broker management system. Verify broker licenses and appointments across multiple state jurisdictions using state regulatory websites. Research and conduct audit review of broker data for credentialing requirements for Broker Accounting to ensure accurate processing of broker commissions.
- Provide comprehensive support to Broker Sales Representatives regarding account-related issues. Respond to routine and ad hoc reporting requests to support BOR Transfers, Block Transfers, Broker/Agency Agreement processing, licensing, insurance verification, and appointment status activities. Serve as a point of contact for audit documentation requests and provide timely feedback upon completion of reviews. Follow established workflows and SOPs related to contracting, compliance, and transfer functions while coordinating effectively with internal and external partners.
- Participate in conference calls and team meetings, contributing ideas and recommendations related to best practices, process improvements, and operational efficiencies. Ensure all contracting and BOR/Block Transfer documentation is accurately maintained within the shared drive. Provide issue resolution and support to external vendors by analyzing and resolving credentialing-related issues affecting withheld commissions and downstream system access.
QUALIFICATIONS:
Education Level: High School Diploma or GED.
Experience: 3 years' customer service, client or broker communication and interaction experience.
Preferred Qualifications:
- 4 years in a customer service environment with experience in health insurance/managed care industry.
Knowledge, Skills and Abilities (KSAs)
- Strong inter-personal and teaming skills.
- High level analytical and statistical ability required to resolve spreadsheet report issues.
- Strong organizational and time management skills; ability to work in a fast-paced environment.
- Ability to interact effectively with people at different organizational levels, both internally and externally.
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range: $42,840 - $78,540
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
#LI-KL1
Resp & Qualifications
PURPOSE:
The Broker Contract II Specialist is responsible for providing comprehensive support and communication to Brokers, Agencies, General Producers (GPs), Full-Service Producers (FSPs), and Broker Sales staff. This role serves as a key coordinator for Individual, Group, Exchange, and Producer agreement reviews, ensuring compliance with contracting, credentialing, and regulatory requirements across MD, DC, and VA markets. The specialist reviews, analyzes, and evaluates documentation to ensure accuracy, compliance, and adherence to established policies and procedures.
ESSENTIAL FUNCTIONS:
- Review and analyze documentation submitted by Brokers, Agencies, GPs, and FSPs to determine the appropriate course of action. Ensure timely and accurate processing of credentialing, Broker of Record (BOR) transfers, Block Transfers, and Broker/Agency Agreements for Individual and Group business while maintaining compliance with departmental standards and regulatory requirements.
- Provide professional, accurate, and timely responses to inquiries from internal and external customers. Utilize independent judgment, analytical skills, and critical thinking to research and resolve broker commission withholding issues, recognizing the financial impact of processing inaccuracies. Leverage proficiency in Microsoft Office applications, including Excel, Word, Outlook, and Teams, to support reporting, communication, documentation, and data analysis activities. Prepare written correspondence related to updates and transfers and maintain adherence to departmental Standard Operating Procedures (SOPs).
- Accurately enter and maintain broker data in Facets billing system to support tracking of BOR and Block Transfer activities. Onboard brokers and agencies by entering and maintaining the Broker/Agency Agreements and credential updates in Salesforce broker management system. Verify broker licenses and appointments across multiple state jurisdictions using state regulatory websites. Research and conduct audit review of broker data for credentialing requirements for Broker Accounting to ensure accurate processing of broker commissions.
- Provide comprehensive support to Broker Sales Representatives regarding account-related issues. Respond to routine and ad hoc reporting requests to support BOR Transfers, Block Transfers, Broker/Agency Agreement processing, licensing, insurance verification, and appointment status activities. Serve as a point of contact for audit documentation requests and provide timely feedback upon completion of reviews. Follow established workflows and SOPs related to contracting, compliance, and transfer functions while coordinating effectively with internal and external partners.
- Participate in conference calls and team meetings, contributing ideas and recommendations related to best practices, process improvements, and operational efficiencies. Ensure all contracting and BOR/Block Transfer documentation is accurately maintained within the shared drive. Provide issue resolution and support to external vendors by analyzing and resolving credentialing-related issues affecting withheld commissions and downstream system access.
QUALIFICATIONS:
Education Level: High School Diploma or GED.
Experience: 3 years' customer service, client or broker communication and interaction experience.
Preferred Qualifications:
- 4 years in a customer service environment with experience in health insurance/managed care industry.
Knowledge, Skills and Abilities (KSAs)
- Strong inter-personal and teaming skills.
- High level analytical and statistical ability required to resolve spreadsheet report issues.
- Strong organizational and time management skills; ability to work in a fast-paced environment.
- Ability to interact effectively with people at different organizational levels, both internally and externally.
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range: $42,840 - $78,540
Salary Range Disclaimer
The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
Equal Employment Opportunity
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Federal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.
PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship
#LI-KL1
About CareFirst BlueCross BlueShield
Named by the Ethisphere Institute as one of the “World’s Most Ethical Companies” for 10 consecutive years.
CareFirst. It’s not just our name. It’s our promise. Over 3.5 million people trust us with their healthcare needs, and we take this responsibility seriously.
Our vision for healthcare is clear. Quality care should be easy to afford, easy to use and available to everyone. And what we’re building for you is exactly what we expect for ourselves and those we love.
Every day, we make a meaningful difference in the communities where we live and work. We solve real problems for the people we serve with equal parts empathy and urgency—simplifying the complex, delivering tailored solutions and stepping forward with new ideas.
RECRUITMENT FRAUD NOTICE: CareFirst is aware of an increase in fraudulent job offers being made on behalf of our recruitment team. Legitimate CareFirst recruiters will always contact you from an email address ending in “@carefirst.com” and will never ask for a payment in exchange for a job opportunity or ask you to submit sensitive personal information via email, phone, or text.
COVID-19 VACCINATION NOTICE: As a leading healthcare organization, it is our responsibility to do our part to help end this pandemic and protect the health and well-being of our members, workforce, communities, businesses and partners. Our recruiters continue to fill open positions. Interviews and other processes are being modified to protect the safety of our candidates and team members. Effective November 1, 2021, COVID-19 full vaccination is required for all employees, including those who work remotely today or in the future. CareFirst will comply with all state and local laws regarding vaccine mandates. Medical and religious exemptions will be made where appropriate using our standard vaccine exemption processes.
Independent licensee of BCBSA.
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