Medicare Member Customer Service

Overview

Medicare Member Customer Service navigators conduct outbound and 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 customer service 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
• Minimum of 1 year experience in working in a call center
• Ability to work a flexible schedule which includes both remote and office-based requirements.
• Proficiency in daily, active use of Excel, CRM systems and the ability to learn other software as needed.
• Active Michigan Life and Health license or ability to obtain within 90 days of employment.

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

Health Alliance Administrators is 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 committed to the hiring, advancement, and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.

Job Type: Full-time

Pay: Up to $21.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• On-the-job training
• Paid time off
• Referral program
• Vision insurance
• Work from home

Experience level:

• 2 years

Shift:

• 8 hour shift
• Day shift

Weekly day range:

• Monday to Friday

Work setting:

• Hybrid work

Application Question(s):

• How many years of health insurance claims or health insurance customer service experience do you have?
• How many years of experience do you have working for a medical insurance carrier?
• Do you have at least 1 year of experience working with Medicare members?
• Do you have an active Michigan Life and Health insurance license or the ability to obtain one within 90 days if offered a position?

Ability to Commute:

• Novi, MI 48375 (Required)

Ability to Relocate:

• Novi, MI 48375: Relocate before starting work (Required)

Work Location: Hybrid remote in Novi, MI 48375