MEDICARE MEMBER SERVICES REPRESENTATIVE - 175375

Job Description

Job Description

MEDICARE MEMBER SERVICES REPRESENTATIVE

Location: Akron, OH 44305
Job Type: Full-Time, Contract
Schedule: Monday–Friday, 8:00 AM–5:00 PM
Work Location: In Office
Pay: $22.25/hour
Weekends: None
Interview: Microsoft Teams

We are hiring a Medicare Member Services Representative in Akron, OH. This is an in-office Monday-Friday position with no weekend requirement.

The ideal candidate will have at least 2 years of health insurance customer service or call center experience, direct experience working with Medicare beneficiaries, and a strong understanding of Medicare Advantage and CMS compliance requirements.

A current health insurance license is REQUIRED.

RESPONSIBILITIES:

• Provide customer service and support to Medicare beneficiaries by phone and in person
• Answer questions regarding Medicare Advantage plans, benefits, networks, pharmacies, and plan options
• Assist members with changing from one Medicare Advantage plan to another
• Complete Medicare Advantage plan changes using compliance-approved scripts
• Communicate plan and product information accurately to Medicare beneficiaries
• Assist members with selecting an appropriate plan based on their needs and the information they provide
• Complete and document plan change requests
• Make outbound calls to Medicare members regarding plan, network, or benefit changes
• Follow up with members who may be at risk for disenrollment
• Support Medicare member retention and outreach programs
• Document all member calls and interactions accurately
• Assist with presenting plan benefit information to individuals or groups when needed
• Track plan change requests and maintain accurate reporting and database information
• Complete required Medicare Advantage plan and product training
• Follow all CMS Medicare Advantage marketing, compliance, and regulatory requirements
• Perform additional administrative duties as assigned

REQUIRED QUALIFICATIONS:

• Active health insurance license REQUIRED
• High school diploma or GED required
• Associate's or Bachelor's degree preferred
• 2+ years of experience in a call center, customer service, or support role within the health insurance industry
• Experience working directly with Medicare beneficiaries
• Knowledge of Medicare and Medicare Advantage
• Understanding of health insurance and Medicare compliance
• Working knowledge of Medicare plan design and benefits
• Knowledge of CMS rules and regulations related to Medicare Advantage
• Excellent phone and customer service skills
• Strong verbal and written communication skills
• Strong listening and critical-thinking skills
• Ability to multitask and navigate multiple computer systems while assisting customers
• Strong attention to detail and organizational skills
• Ability to work independently and as part of a team
• Ability to handle difficult or sensitive customer interactions professionally

SYSTEMS / COMPUTER SKILLS:

Candidates must be comfortable using multiple computer systems simultaneously while speaking with members, including CRM systems, member documentation systems, plan information platforms, websites, and telephone systems.

TRAINING REQUIREMENT:

Selected candidates must successfully complete required Medicare Advantage plan and product training prior to the open enrollment season, including achieving a minimum passing score of 90%.

INTERVIEW REQUIREMENT:

Microsoft Teams interview required. Please provide candidate availability for an interview when submitting.

KEYWORDS:

Medicare, Medicare Advantage, Medicare Member Services, Health Insurance, Health Insurance Customer Service, Health Insurance Call Center, Medicare Customer Service, Medicare Beneficiaries, CMS, CMS Compliance, Medicare Compliance, Medicare Enrollment, Medicare Plans, Member Services Representative, Customer Service Representative, Health Insurance Representative, Insurance License, Medicare Advantage Plans, AEP, Open Enrollment, Healthcare Customer Service, Call Center Representative, Insurance Customer Service