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 handle 40+ inbound calls daily in a fast-paced call center environment, providing resolutions or pathways to resolution while delivering a perfect call experience.

About the role

• Perform varied activities and moderately complex administrative, operational, and customer-support tasks
• Address member needs, including complex benefits questions, issue resolution, and member education
• Accurately record details of inquiries, comments, complaints, transactions, or interactions
• Take prompt and appropriate 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 (escalations), based on business needs

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 (except for Humana-observed holidays). Camera must remain on, with your face clearly visible.
• 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.
• Overtime/Weekends: Some weekends and overtime may be required, especially during peak season (October through March). No time off is allowed in January (except Humana-observed holidays). Advance notice for overtime/weekends is typically provided, but business needs may shorten this.
• 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 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; see below)

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

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off (including paid holidays, parental leave, and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Additional opportunities for personal wellness and career development

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 speaking with members in a language other than English must pass a language proficiency assessment (Interagency Language Rating/ILR test).
• Career Growth: Associates must remain in their position for 12 months before applying for other roles, unless business needs dictate otherwise.