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.

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, addressing member needs such as complex benefits questions, issue resolution, and education. Decisions are typically focused on interpreting department policies and methods, with minimal direction and some latitude for prioritization.

• Accurately record details of inquiries, comments, complaints, transactions, or interactions.
• Take prompt and appropriate action, including escalating unresolved or pending member grievances.
• Work under defined parameters with standard policies, allowing some opportunity for interpretation and independent discretion.
• Occasionally assist with other lines of business, such as 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. Your camera must remain on, and your face must be fully visible.
• Post-Training: 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.
• Peak Season: Some weekends and overtime may be required, especially from October through March. No time off is allowed in January (except Humana-observed holidays). Advance notice for weekends/overtime is typically provided, though business needs may shorten this timeframe.
• 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’s offices for training or meetings may be required.
• Minimum internet speed: 25 Mbps download and 10 Mbps upload (Humana reserves the right to require upgrades 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; 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.

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) provided by an outside vendor to ensure competency.

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.
• Career development opportunities, with a 12-month tenure requirement for internal position applications (exceptions may apply).