Medicare Retention Specialist

Position Summary The Medicare Retention Specialist is responsible for supporting member retention efforts by providing exceptional customer service to Medicare Advantage members. This role focuses on addressing member concerns, resolving issues, and educating members on plan benefits to improve satisfaction and reduce voluntary disenrollment. This is an entry‑level position ideal for candidates interested in healthcare, insurance, or customer service careers. Position is fully onsite. Schedule is Monday – Friday from 8:00 AM – 5:00 PM. Essential Duties and Responsibilities Respond to inbound and outbound calls from Medicare members regarding plan questions, concerns, and potential disenrollment requests. Identify at‑risk members and take proactive steps to improve retention. Educate members on plan benefits, coverage, and available resources. Resolve member issues related to claims, billing, pharmacy, and provider access. Document all interactions accurately in the system in compliance with CMS guidelines. Collaborate with internal departments (claims, enrollment, provider relations) to resolve escalated member issues. Follow all compliance and regulatory requirements related to Medicare Advantage plans. Meet performance metrics such as call quality, productivity, and retention goals. Supervisory Responsibility None. Qualifications and Education Required Qualifications High school diploma or equivalent. 1–2 years of experience in customer service, call center, or healthcare environment. Bilingual (English/Spanish). Strong verbal and written communication and problem- solving skills. Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new systems quickly). Ability to handle sensitive situations with empathy and professionalism. High level of professionalism and ability to handle confidential information. Preferred Qualifications Experience working with Medicare or health insurance plans. Knowledge of CMS regulations (a plus, not required). Prior experience in retention efforts. Core Competencies Empathy and emotional intelligence. Customer focus and service excellence. Problem solving and critical thinking. Communication skills (verbal and written). Team collaboration, works efficiently with internal departments. Working Conditions Moderate noise level. Works indoors; occasional field interactions with patients and staff. Requires frequent lifting up to 10 pounds, occasional up to 25 pounds, standing, walking, and use of hands for repetitive motions. #J-18808-Ljbffr Solis Health Plans