Medicare Call Center Representative

About the role

Represent Humana by addressing incoming telephone, digital, or written inquiries from Group or Individual Medicare members. Perform varied activities and moderately complex administrative, operational, and customer support tasks, including computations. Handle 40+ inbound calls daily in a fast-paced call center environment, providing resolutions or pathways to resolution while ensuring a perfect call experience. Address member needs such as complex benefits questions, issue resolution, and education.

This is a high-volume call center setting that may be stressful at times. Accurately record details of inquiries, comments, complaints, transactions, or interactions, and take prompt action, including escalating unresolved or pending member grievances. Decisions typically focus on interpreting department policies and methods for completing assignments with some latitude over prioritization and timing.

This opportunity involves working in a call center environment to support Humana Medicare members. As part of career development, you may be asked to assist with other lines of business, including Member Solutions for escalations, based on business requirements.

Schedule

Training 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. Your camera must remain on, showing your entire face from the shoulders up, with no obstructions. Should a Humana-observed holiday occur during training or within the initial 120 days of employment, you will have the holiday off (paid).

Post-Training Schedule: 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 of each year, except for Humana-observed holidays. Advance notice for required weekends or overtime will be provided when possible, though business needs may not always allow for a week’s notice.

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

Responsibilities

• Address member inquiries via phone, digital, or written channels, providing resolutions or pathways to resolution.
• Handle complex benefits questions, resolve issues, and educate members.
• Manage 40+ inbound calls daily in a high-volume call center environment.
• Accurately document details of inquiries, complaints, transactions, or interactions.
• Take prompt action on member grievances, escalating unresolved or pending issues as needed.
• Interpret and apply department policies and methods to complete assignments.
• Assist with other lines of business, such as Member Solutions for escalations, based on business requirements.

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).
• Work from a dedicated space free of ongoing interruptions to protect member PHI/HIPAA information.
• Occasional travel to Humana offices for training or meetings may be required.

Internet Connection Requirements: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required. Humana reserves the right to require associates to upgrade their internet service if necessary.

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).

Language Proficiency Testing: Associates who speak with members in a language other than English must take a language proficiency assessment (Interagency Language Rating test) provided by an outside vendor to ensure competency.

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.
• Additional opportunities for personal wellness and smart healthcare decisions.