Provider Data Entry Specialist - Medicare

Medicare Advantage Call Center Representative

Contract | Fully Remote | Month-to-Month

Compensation

• $20.00/hour
• W2 contract position
• Fully remote
• Month-to-month engagement with potential extension based on business needs

About the Opportunity

We're looking for experienced Medicare Advantage Customer Service Representatives to support members and providers during a Medicare Advantage plan wind-down. This team serves as the primary point of contact for questions related to run-out claims, coverage transitions, provider payments, Explanation of Benefits (EOBs), refunds, and other post-coverage inquiries.

This is a high-volume customer service environment with the majority of calls coming from healthcare providers regarding claim status and payment questions.

Responsibilities

• Handle inbound and outbound calls from Medicare Advantage members and healthcare providers.
• Respond to questions regarding claim status, provider payments, Explanation of Benefits (EOBs), refunds, and coverage transitions.
• Research customer issues and provide accurate, timely resolutions.
• Escalate complex issues to the appropriate internal teams.
• Document all customer interactions accurately.
• Meet established productivity, quality, and customer service metrics.
• Complete all required training on internal systems and processes.

Qualifications

• Previous Medicare Advantage call center experience is required.
• Excellent verbal English communication skills.
• Strong customer service and problem-solving abilities.
• Comfortable working in a fast-paced, high-volume call center environment.
• Ability to work independently from home with reliable internet and a distraction-free workspace.
• Must successfully pass a background check.

Schedule

• Shifts scheduled between 8:00 AM and 10:00 PM Eastern
• Multiple shift options available based on business needs