Member Services Specialist (4pm to 8pm EST)

Responsibilities

• Responds to Member/Provider questions via telephone and written correspondence regarding Medicare benefits, enrollment questions, change requests, eligibility, and claims.
• Analyzes problems and provides information/solutions.
• Utilizes internal systems to obtain and extract information, documents information, activities, and changes in the database.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive member/provider relations and coordinates with various functions within the company to ensure requests and questions are handled appropriately and in a timely manner.
• Researches and analyzes data to address operational challenges and member/provider service issues.

Qualifications

• H.S. graduate or GED;
• Health insurance experience required.
• Medicare experience preferred.
• Medicare Advantage plans experience is a bonus.
• Customer service and Call center experience preferred.
• Proficient written and oral communication skills required.
• Compliance, at all times, with CMS regulations regarding Medicare Advantage Plans
• Exceptional interpersonal skills with demonstrated ability to work independently as well as with a team;
• Exceptional organizational skills
• Proficiency in computer skills including Microsoft Office Suite products