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 will provide resolutions or pathways to resolution on each call while delivering a perfect call experience, handling complex benefits questions, resolving issues, and educating members.

About the role

This position involves performing varied activities and moderately complex administrative, operational, and customer support tasks. You will handle 40+ inbound calls daily in a fast-paced call center environment, accurately recording details of inquiries, transactions, or interactions, and escalating unresolved issues as needed. Decisions typically focus on interpreting department policies and methods, with some latitude for prioritization and independent discretion.

Responsibilities

• Address member needs, including complex benefits questions, issue resolution, and education.
• Handle high-volume inbound calls in a fast-paced call center setting.
• Accurately document inquiries, comments, complaints, transactions, or interactions.
• Take prompt action, including escalating unresolved or pending member grievances.
• Follow standard policies and practices with some opportunity for interpretation or deviation.
• Assist with other lines of business as needed, including Member Solutions for escalations.

Schedule

• Training: Virtual training starts on day one and runs for 12 weeks, Monday through Friday, 8:00 AM to 4:30 PM EST. Attendance is mandatory, with no time off allowed. Camera must remain on, showing your full face from the shoulders up.
• 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 for Humana-observed holidays. Advance notice for weekends/overtime is provided when possible.
• 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 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.
• 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

• 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 (exceptions may apply).