Eligibility Associate Representative

Eligibility Associate Representative (Customer Service Representative)

Location: Fully Remote (U.S. Based)

Eligible States: All U.S. states except New York, California, Hawaii, and Alaska

Pay Range: $21.00 $26.00 per hour

Start Date: July 2026

Assignment Length: through December 2026, with potential for extension and conversion depending on performance, attendance, & business needs

Schedule: Full-time; candidates must be available to work between 8:00 AM 8:00 PM based on local time zone. Evening, weekend, holiday, rotating shifts, and overtime may be required based on business needs.

About the Role

We are seeking a customer-focused and detail-oriented Eligibility Associate Representative (CSR) to join our Medicare Customer Support team. In this role, you will deliver exceptional service to existing HealthSpring Medicare members by assisting with plan changes, explaining benefits, and resolving inquiries in a fast-paced, high-volume call center environment. The ideal candidate is an effective communicator with strong problem-solving abilities, a passion for helping customers, and the ability to navigate multiple systems efficiently while maintaining compliance standards.

What We're Looking For

The ideal candidate is professional, patient, adaptable, and customer focused. Successful individuals in this role are able to:

• Build rapport and trust with customers
• Ask thoughtful questions to understand member needs
• Clearly explain healthcare plan information
• Remain calm and solution-oriented in challenging situations
• Thrive in a structured, metrics-driven environment
• Balance empathy, efficiency, and compliance in every customer interaction

Key Responsibilities

• Handle inbound calls from current HealthSpring Medicare customers regarding:
• Plan-to-plan changes
• Benefit explanations
• General account inquiries
• Transfers to appropriate departments when needed
• Conduct occasional outbound calls to educate members on available Medicare plan options
• Deliver accurate, compliant, and customer-centered support using approved scripts, tools, and resources
• Maintain up-to-date knowledge of Medicare products, policies, procedures, and compliance requirements
• Accurately document customer interactions and maintain high-quality data entry standards
• Navigate multiple systems and applications simultaneously while managing customer conversations effectively
• Participate in required trainings, team meetings, coaching sessions, and ongoing development activities
• Maintain active licensing and appointments in applicable HealthSpring Medicare markets
• Consistently demonstrate professionalism, empathy, accountability, and a positive attitude
• Meet productivity, attendance, quality, and customer experience expectations
• Support business operations through flexible scheduling, including evenings, weekends, holidays, rotating shifts, and overtime as needed

Required Qualifications

• High School Diploma or GED equivalent required, Bachelor's degree preferred
• Active Health Insurance License in residential state required
• Minimum 12 years of customer service and/or sales experience
• Ability to work effectively in a fast-paced, high-volume call center environment
• Strong multitasking and time management skills with the ability to prioritize competing tasks
• Ability to work independently in a remote environment while remaining highly productive and engaged
• Demonstrated attention to detail and accurate data entry skills
• Proficiency with Microsoft Office Suite, including Outlook, Excel, Word, and Teams
• Experience utilizing scripts, tools, and technology to support customer interactions
• Understanding of Medicare products including:
• Medicare Advantage
• Medicare Supplement
• Part D
• Ancillary products
• Ability to adapt quickly to changing business needs, processes, and systems
• Strong commitment to compliance, quality standards, and exceptional customer service

**Upon acceptance of the offer, you will be required to submit to a background check, including employment and education verifications and urinalysis drug screening**