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 data recording.

About the role

In this position, you will strive to provide each caller with a resolution or clear pathway to resolution while delivering a perfect call experience. Responsibilities include addressing complex benefits questions, resolving issues, educating members, and handling 40+ inbound calls daily in a fast-paced call center environment. You will accurately document details of inquiries, comments, complaints, transactions, or interactions and take prompt action, including escalating unresolved or pending member grievances.

Decisions typically involve interpreting department policies and methods for completing assignments. You will work under minimal direction within defined parameters, with some latitude over prioritization and timing, following standard policies and practices that allow for interpretation and independent discretion.

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 record details of inquiries, comments, complaints, transactions, or interactions
• Take prompt and appropriate action, including escalating unresolved or pending member grievances
• Interpret area and department policies to guide decision-making on assignments
• Assist with other lines of business as needed, including Member Solutions for escalations

Schedule

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 except for Humana-observed holidays. Following 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 except for Humana-observed holidays. Advance notice for required weekends or overtime will be provided when possible.

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 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 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.

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

All associates are subject to a 180-day appraisal period. Career growth is strongly supported, though associates must typically be in their current position for 12 months before applying for other roles unless business needs dictate otherwise.

Additional Information

• Internet connection must meet minimum requirements: download speed of 25 Mbps and upload speed of 10 Mbps (wired cable or DSL suggested)
• Bilingual associates must take a language proficiency assessment (Interagency Language Rating test) to ensure competency