Medicare Call Center Representative

Become a part of our caring community as a Medicare Call Center Representative, addressing incoming telephone, digital, or written inquiries from Humana’s Group or Individual Medicare members. You’ll perform varied activities and moderately complex administrative, operational, and customer support tasks, including computations and problem resolution.

About the role

• Provide resolutions or clear pathways to resolution for Medicare members on each call, ensuring a perfect call experience
• Address member needs, including complex benefits questions, issue resolution, and education
• Handle 40+ inbound calls daily in a fast-paced call center environment
• Accurately record details of inquiries, comments, complaints, transactions, or interactions, and take prompt action, including escalating unresolved or pending member grievances
• Work under minimal direction within defined parameters, with some latitude over prioritization and timing
• Follow standard policies and practices, allowing for interpretation and independent discretion
• Occasionally assist with other lines of business, such as Member Solutions for escalations, based on business requirements

Schedule

• Training: Virtual training starts on day one and runs for the first 12 weeks, Monday through Friday, 8:00 AM to 4:30 PM EST. Attendance is mandatory, with no time off allowed during training. Camera must remain on, showing your full face from the shoulders up.
• Post-Training: Assigned to an 8-hour shift between 8:00 AM and 8:00 PM Eastern Time, Monday through Friday. Shift bids occur periodically based on performance and business needs.
• Peak Season (October–March): Some weekends and overtime may be required, with a minimum of one week’s advance notice when possible. No time off is allowed in January (except Humana-observed holidays).
• Appraisal Period: All associates are subject to a 180-day appraisal period.

Requirements

• Minimum of 2 years of customer service experience
• Demonstrated experience providing strong customer service, using effective communication skills, and actively listening to customer needs
• Ability to manage multiple or competing priorities, including using multiple computer applications and systems simultaneously
• Proficiency with Microsoft Office applications, particularly Outlook and Teams
• Hard-wired internet connection (wireless, satellite, cellular, and microwave connections are not permitted)
• Dedicated workspace free from ongoing interruptions to protect member PHI/HIPAA information
• Occasional travel to Humana’s offices for training or meetings may be required

Preferred Qualifications

• Previous inbound call center or related customer service experience
• Previous healthcare experience
• Associate or Bachelor’s degree
• Bilingual in Spanish and English (requires language proficiency testing)

Pay

The pay rate for this position is $19.24 per hour ($20.24 for Spanish/English bilingual associates who pass language proficiency testing). This rate is non-negotiable.

Estimated Annual Pay Range: $39,000 – $49,400 per year for full-time (40 hours per week) employment. Pay may vary based on geographic location and individual qualifications.

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off, including company and personal holidays, paid parental and caregiver leave
• Short-term and long-term disability
• Life insurance
• Career development opportunities, including support for internal mobility after 12 months in the role (exceptions may apply)

Additional Information

• Internet Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps (wired cable or DSL connection suggested). Humana reserves the right to require upgrades if necessary.
• Language Proficiency Testing: Associates who speak with members in a language other than English must take a language proficiency assessment (e.g., Interagency Language Rating (ILR) test).