Key Responsibilities and Required Skills for Licensed Insurance Representative

🎯 Role Definition

The Licensed Insurance Representative is a licensed sales and service professional who markets, quotes, sells, and services insurance and financial protection products (life, health, property & casualty, Medicare, annuities), maintains compliance with state insurance regulations, and builds long-term client relationships. This role blends consultative sales, benefits counseling, policy administration, claims triage, and compliance stewardship. Ideal candidates are licensed in the relevant product lines, skilled with CRM and quoting tools, and motivated by client outcomes and growth metrics.

📈 Career Progression

Typical Career Path

Entry Point From:

Customer Service Representative (insurance or benefits)
Unlicensed Sales Representative / Appointment Setter
Call Center Insurance Representative

Advancement To:

Senior Licensed Representative / Senior Account Executive
Sales Manager / Agency Manager
Insurance Broker / Producer
Regional Sales Director or Territory Manager

Lateral Moves:

Claims Adjuster or Claims Specialist
Underwriting Assistant / Underwriter
Benefits Specialist or Employee Benefits Consultant

Core Responsibilities

Primary Functions

Conduct needs analyses and benefits reviews with prospective individual and small-business clients to recommend appropriate insurance products (life, health, disability, dental, vision, property & casualty, Medicare Advantage/Part D, annuities) that meet financial objectives and risk tolerance.
Generate and cultivate sales leads through outbound prospecting, warm transfers, referrals, appointment setting, community outreach, and digital marketing channels; convert leads into submitted applications and bound policies.
Prepare accurate, competitive insurance quotes using internal quoting tools, carrier portals and comparative rate engines; explain product features, benefits, exclusions, riders, premiums and policy terms in plain language.
Complete and submit applications, endorsements, renewals, and required documentation to carriers; follow up on conditional requirements (medical records, signatures, payments) to ensure timely underwriting and policy issuance.
Maintain and grow a personal book of business by conducting renewal reviews, cross-selling complementary products (e.g., bundling home and auto, adding life to health plans), and proactively addressing client lifecycle events (marriage, new home, retirement).
Serve as the primary point of contact for policy servicing: process address changes, beneficiary updates, billing inquiries, cancellations, reinstatements, and mid-term policy modifications while ensuring data accuracy.
Educate clients on regulatory programs and eligibility criteria (Medicare enrollment periods, open enrollment, special enrollment, COBRA rules) and assist with plan comparisons and enrollment submissions.
Facilitate claims intake and triage; assist clients in submitting claims, explain claims procedures, and coordinate with carrier claims teams to expedite resolution when appropriate.
Maintain up-to-date, compliant licensing and continuing education for applicable product lines and states; complete carrier contracting and appointments and ensure all licensing paperwork is current.
Monitor carrier underwriting and rate changes, product launches, and regulatory updates; communicate plan changes and renewal impacts to clients and adjust recommendations as needed.
Use CRM systems (e.g., Salesforce, AgentCubed, AgencyBloc) to document all client interactions, track sales pipelines, schedule follow-ups, and maintain accurate client records to support compliance and retention efforts.
Hit monthly and quarterly sales targets and KPIs (applications submitted, policies bound, persistency, conversion rates) while maintaining high levels of customer satisfaction and retention.
Conduct personalized benefits counseling sessions for individuals, families and employer groups, including plan design recommendations, employee communication support, and on-site or virtual enrollment events.
Coordinate with internal underwriting, product specialists, case managers, and carrier representatives to resolve complex cases and secure favorable underwriting outcomes for clients.
Ensure all sales and service activities comply with federal and state insurance regulations, HIPAA, carrier rules, and internal audit standards; prepare documentation for audits and compliance reviews.
Produce and deliver persuasive, compliant sales presentations and proposals for individual and business prospects; tailor messaging to the audience (employee groups vs. individual consumers).
Collect payments, process EFTs/credit card transactions, and reconcile premium accounting details; assist clients with billing plan selection and autopay setup.
Leverage analytics and client segmentation to prioritize high-opportunity accounts, drive retention strategies, and identify cross-sell/up-sell opportunities that increase client lifetime value.
Mentor and train new licensed representatives on carrier platforms, quoting tools, best practices, and compliance expectations; participate in product training and sales enablement sessions.
Resolve escalated customer service issues promptly and empathetically, documenting root causes and implementing process improvements to reduce future escalations.
Participate in community outreach, seminars, employer benefits fairs, and virtual campaigns to build local brand awareness and generate qualified leads.
Maintain a professional regulatory file for each client interaction that includes disclosures, consent forms, and record of advice in accordance with company policy and state law.

Secondary Functions

Support marketing initiatives by providing product content, client testimonials, and local market insight for digital campaigns and email nurture sequences.
Assist the operations team with carrier onboarding tasks, data reconciliation, and process documentation to improve policy issuance speed.
Participate in multi-disciplinary project teams to pilot new quoting tools, CRM integrations, or customer communication workflows.
Track and report competitive intelligence on carrier plans, network changes, and rate movements to inform product positioning.
Contribute to knowledge base and standard operating procedures for policy servicing, enrollment checklists, and compliance checklists.

Required Skills & Competencies

Hard Skills (Technical)

Active state insurance licenses for relevant lines: Life & Health, Property & Casualty, and/or Medicare (AHIP certification preferred for Medicare products).
Proven proficiency with insurance CRM systems (Salesforce, AgencyBloc, Applied Epic, Vertafore), quoting engines, and carrier portals.
Strong quoting and illustration skills for life insurance, annuities, and group benefit plans using industry tools and rate tables.
Solid understanding of underwriting guidelines, medical underwriting processes, and ability to manage conditional requirements.
Knowledge of Medicare rules and enrollment periods, Qualified Health Plans (ACA), employer-sponsored group benefits, and COBRA administration.
Experience with electronic application platforms (e-App), e-signature technology, and digital enrollment systems.
Competence in premium billing, EFT/ACH setup, commission schedules, and basic reconciliation of client accounts.
Familiarity with compliance workflows, recordkeeping for audits, HIPAA privacy standards, and state-specific insurance regulations.
Ability to read and interpret policy contracts, endorsements, riders, exclusions, and limits.
Proficiency with Microsoft Office suite (Excel for commission and renewal schedules, Word for proposals, Outlook for client communication) and virtual meeting tools.
Experience with customer analytics and pipeline management to forecast sales and retention metrics.
Basic knowledge of group benefits plan design and employee communication strategies.

Soft Skills

Consultative selling: ability to listen, diagnose needs, and recommend tailored insurance solutions.
Exceptional verbal and written communication skills for client education, presentations, and negotiation.
High emotional intelligence and empathy for handling sensitive client situations (claims, medical issues, financial stress).
Strong time management and organizational skills to manage a high-volume pipeline and multiple client touchpoints.
Problem-solving and critical thinking to navigate complex underwriting and claims situations.
Resilience and persistence in outbound prospecting and converting leads.
Attention to detail to ensure accurate applications, compliance, and billing.
Customer-focused mindset and commitment to delivering high-quality service and building long-term relationships.
Team collaboration skills to work with underwriting, claims, sales support, and operations.
Ethical conduct and professional integrity in all client interactions and recordkeeping.

Education & Experience

Educational Background

Minimum Education:

High school diploma or GED required; completion of required pre-licensing coursework.

Preferred Education:

Bachelor’s degree in Business, Finance, Insurance, Risk Management, Marketing, Human Resources or related field.

Relevant Fields of Study:

Insurance, Risk Management, Finance
Business Administration, Marketing
Human Resources, Health Administration

Experience Requirements

Typical Experience Range:

1–5 years of experience in insurance sales, benefits enrollment, customer service, or a licensed representative role.

Preferred:

3+ years of licensed selling experience with a proven track record of meeting sales targets, managing renewals, and maintaining persistency.
Experience selling Medicare, ACA plans, group benefits, or property & casualty products depending on role focus.
Demonstrated experience using CRM and quoting tools, and a history of maintaining compliance with state insurance regulations.