Medicare Member Experience Specialist

Medicare Member Experience Specialist

Overview

Medicare Member Experience Specialists conduct outbound and receive inbound calls to Medicare members who have enrolled in the carrier’s plan. Their goal is to provide education about the features, functions, and benefits of their chosen Medicare plan and assisting members with any barriers to accessing care. They will also handle incoming calls from members going above and beyond to ensure Medicare members have the information they need to utilize their benefits.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Make proactive outreach to members via telephone to provide education and assistance regarding the Medicare benefits.

Respond to complex Medicare beneficiary questions about plan benefits and accessing care.

Candidates must:

• Have knowledge and understanding of Medicare products and services.
• Efficiently manage the designated work lists
• Follow all regulatory guidelines, scripting and policies.
• Demonstrate and maintain knowledge of all state and regulatory guidelines by adhering to program requirements implemented by CMS (Centers for Medicaid and Medicare Services).

Experience:

• Minimum of 2 years claims/customer service experience at a medical health insurance carrier.
• Minimum of 1 year experience in working directly with Medicare members.
• Must be located in Michigan with the ability to commute to and work from our southeast Michigan office locations.
• Proficiency in daily, active use of Excel, CRM systems and the ability to learn other software as needed.

Behaviors

• Commitment and dependability.
• Excellent oral and written communication skills.
• Ability to engage seniors with sincerity.
• Ability to confidently learn new computer programs, such as customer relationship management software.
• Excellent organizational and planning skills.
• Ability to communicate effectively with a broad cross section of people.
• Ability to self-motivate.
• Consistently demonstrates high levels of integrity.

Education

Bachelor’s degree preferred, experience in lieu of degree will be considered.

Equal Employment Opportunity/Affirmative Action Employer

At Health Alliance Administrators, we are committed to fostering, cultivating, and embracing a culture of inclusion and equality. We welcome and encourage diversity in the workplace and are fully committed to promoting and preserving an environment that supports growth and advancement in all aspects of business.

Health Alliance Administrators is an equal opportunity employer and will not unlawfully discriminate against qualified applicants with respect to any terms or conditions of employment based on race, color, national origin, ancestry, gender, sexual orientation, age, religion, creed, marital status, military service status, union/non-union activity, citizenship status or other characteristic protected by state of federal law or local ordinance. This includes compliance with all federal, state and local laws providing for nondiscrimination on the basis of disability in all aspects of the employment process and the requirement to provide reasonable accommodations to qualified individuals with disabilities in accordance with those laws.

Job Type: Full-time

Pay: $20.00 - $21.00 per hour

Work Location: Hybrid remote in Michigan

License/Certification:

• Michigan Life and Health Insurance license (Preferred)