Medicare Call Center Representative

About the role

Represent Humana by addressing incoming telephone, digital, or written inquiries from Group or Individual Medicare members. Strive to provide each member with a resolution or pathway to resolution on every call, delivering a perfect call experience. Handle 40+ inbound calls daily in a fast-paced call center environment, addressing complex benefits questions, resolving issues, and educating members. Accurately record details of inquiries, transactions, or interactions and take prompt action, including escalating unresolved member grievances.

Decisions typically focus on interpretation of department policy and methods for completing assignments. Work under minimal direction within defined parameters, with some latitude over prioritization and timing. Follow standard policies and practices that allow for interpretation, deviation, and independent discretion.

This is a remote position with occasional travel to Humana's offices for training or meetings. You may be asked to assist with other lines of business, including Member Solutions for escalations, based on business requirements.

Responsibilities

• Address member needs, including complex benefits questions, issue resolution, and education.
• Handle 40+ inbound calls daily in a high-volume call center environment.
• Accurately document inquiries, comments, complaints, transactions, and interactions.
• Take prompt and appropriate action, including escalating unresolved or pending member grievances.
• Manage multiple or competing priorities, including the use of multiple computer applications simultaneously.
• Assist with other lines of business as needed, such as Member Solutions for escalations.

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.
• Experience managing multiple or competing priorities, including the use of 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.

Qualifications

• Previous inbound call center or related customer service experience (preferred).
• Previous healthcare experience (preferred).
• Associate or Bachelor's degree (preferred).
• Bilingual in Spanish and English (see Language Proficiency Testing below; preferred).

Schedule

Virtual training starts on day one and runs for the first 12 weeks with a schedule of 8:00 AM to 4:30 PM EST, Monday through Friday. Attendance is mandatory, with no time off allowed during training except for Humana-observed holidays. Camera must remain on for the entire duration of training and other required meetings.

After training, you will be assigned 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. Some weekends and overtime may be required, especially during peak season (October through March) and as needed by the business. No time off is allowed in January of each year, except for Humana-observed holidays. Advance notice for required weekends or overtime will be provided when possible.

All associates are subject to a 180-day appraisal period.

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.

Scheduled weekly hours: 40.

Benefits

Humana offers competitive benefits designed to support whole-person well-being, including:

• 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.

Additional Information

• Language Proficiency Testing: Associates who speak with members in a language other than English must take a language proficiency assessment (Interagency Language Rating/ILR test) to ensure competency.
• Internet Connection Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps is required. Humana reserves the right to require associates to upgrade their internet service if necessary.