Member Services Representative - Medicare Advantage

Job Description

Job Description

A-Line Staffing is seeking a motivated and detail-oriented  Medicare Advantage Member Services Representative This role offers career growth, a supportive work environment, and full-time hours (40+ per week).

If interested in this  Medicare Advantage Member Services Representative  position APPLY NOW for IMMEDIATE consideration

MEDICARE ADVANTAGE MEMBER SERVICES REPRESENTATIVE | DETAILS AND COMPENSATION:

• Location: Akron OH 44305 – 100% on-site
• Payrate: $20/hr, non-licensed | $22.50/hr, licensed
• Required Availability: Full-Time | Monday – Friday, 8:00 AM–5:00 PM

MEDICARE ADVANTAGE MEMBER SERVICES REPRESENTATIVE | SUMMARY AND HIGHLIGHTS:

The  Medicare Advantage Member Services Representative  will support Medicare Advantage members through phone-based customer service, plan education, and enrollment-related activities. This role is ideal for someone with experience working with  Medicare beneficiaries and health insurance , particularly in a call center or customer service environment.

• This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs
• Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

MEDICARE ADVANTAGE MEMBER SERVICES REPRESENTATIVE | RESPONSIBILITIES:

• Complete Medicare Advantage plan changes over the phone using compliance-approved scripts.
• Accurately document all member interactions and calls.
• Make outbound calls to Medicare members as needed, particularly during Annual Enrollment Period (AEP).
• Follow up with members who may be at risk for disenrollment and participate in retention outreach programs.
• Provide personalized assistance regarding plan benefits, provider networks, pharmacy questions, and plan changes.
• Educate Medicare beneficiaries about available plan options and assist them in selecting a plan based on their needs and preferences.
• Complete plan change requests between Medicare Advantage plans.
• Assist with tracking and monitoring plan change requests and maintaining accurate reporting.
• Support presentations of plan benefit information to groups or individuals in person, as needed.
• Ensure members understand their available product and plan choices during the enrollment process.
• Maintain compliance with CMS regulations, marketing guidelines, and company policies and procedures.
• Use multiple systems simultaneously, including CRM, member documentation, plan information, website, and telephone systems.
• Perform administrative and reporting duties as assigned by management.

MEDICARE ADVANTAGE MEMBER SERVICES REPRESENTATIVE | REQUIREMENTS :

• Education: High School Diploma or GED (verifiable) | Associate's or bachelor's degree preferred.
• Attendance: Commitment to mandatory attendance during the first 90 days.
• 2+ years of experience in a call center, customer service, or support role  MUST be within the health insurance industry.
• Experience working directly with  Medicare beneficiaries required.
• Understanding of Medicare and health insurance compliance requirements  required .
• Working knowledge of Medicare, plan design, and health insurance benefits.
• Knowledge of CMS rules and regulations related to  Medicare Advantage plans .
• Ability to multitask and navigate multiple computer systems while assisting members.
• Ability to handle a moderately stressful environment and effectively calm and reassure members when needed.

Preferred Qualifications

• Active health insurance license is preferred but not required.
• Experience with CRM and member documentation systems.
• Experience with Salesforce or similar customer relationship management platforms.

Training & Compliance

• Selected candidates must successfully complete required plan and product training prior to the open enrollment season, including achieving a minimum 90% passing score.
• Candidates must be able to follow federal and state regulatory requirements, CMS marketing guidelines, and company compliance policies.

Take the Next Step!

Join a company that values your growth and contributions. If you’re interested in the Medicare Advantage Member Services Representative role apply now or contact us for immediate consideration!

Brittney Blackman