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 perform varied activities and moderately complex administrative, operational, and customer support tasks, including computations, while working on semi-routine assignments.

About the role

In this position, you will strive to provide Medicare members with a resolution or pathway to resolution on each call, delivering a perfect call experience. You’ll address member needs, including complex benefits questions, issue resolution, and education. Expect to handle 40+ inbound calls daily in a fast-paced call center environment, accurately documenting inquiries, complaints, or transactions and escalating unresolved issues as needed.

Decisions typically involve interpreting department policies and methods, with some latitude for prioritization and independent discretion. You’ll work under minimal direction, following standard practices while having opportunities for interpretation and deviation.

Responsibilities

• Resolve member inquiries via phone, digital, or written channels, ensuring a perfect call experience.
• Address complex benefits questions, resolve issues, and educate members on Medicare-related topics.
• Handle 40+ inbound calls daily in a high-volume call center environment.
• Accurately record details of inquiries, complaints, transactions, or interactions.
• Take prompt action, including escalating unresolved or pending member grievances.
• Manage multiple priorities, including simultaneous use of computer applications and systems.
• Assist with other lines of business as needed, such as Member Solutions for escalations.

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.
• 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.

Qualifications

• Prior experience managing multiple or competing priorities, including simultaneous use of computer applications.
• Strong attention to detail.

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).

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. Camera must remain on, and attendance is mandatory with no time off allowed (except for Humana-observed holidays).
• 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: 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 provided when possible.

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.
• Additional opportunities for personal wellness and career development.