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 environment, providing resolutions, answering complex benefits questions, resolving issues, and educating members while ensuring a perfect call experience.

Responsibilities

• Address member needs, including complex benefits questions, issue resolution, and education.
• Accurately record details of inquiries, comments, complaints, transactions, or interactions.
• Take prompt and appropriate action, including escalating unresolved and pending member grievances.
• Perform computations and manage varied administrative, operational, and customer support tasks.
• Work within defined parameters to identify work expectations and quality standards, with some latitude over prioritization and timing.
• Follow standard policies and practices, allowing for interpretation, deviation, and independent discretion.
• Assist with other lines of business as needed, including 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 (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.
• 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 member 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). Minimum download speed of 25 Mbps and upload speed of 10 Mbps required.
• Work from a dedicated space free of ongoing interruptions to protect member PHI/HIPAA information.
• Occasional travel to Humana’s offices for training or meetings may be required.

Qualifications

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

• Base pay rate: $19.24 per hour ($20.24 for Spanish/English bilingual associates; requires language proficiency testing).
• Annual pay range for full-time (40 hours per week): $39,000 – $49,400, varying 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.

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).
• This is a remote position, but occasional travel to Humana offices may be required.