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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare enrollment processes, billing, and claims management while providing exceptional customer service. Proficient in navigating multiple client systems and adhering to regulatory guidelines to ensure accurate information delivery.
Highest-signal resume keywords
Medicare EnrollmentCustomer Service ExperienceProblem-Solving SkillsRegulatory ComplianceMultitasking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims ManagementBillingEligibility VerificationInvoicingMedicare Part DMedicare Part CDual Special Need ProgramsTyping ProficiencySystem NavigationCall Handling
Soft Skills
Active ListeningCourteous ServiceCommunication SkillsFollow-Up SkillsFlexibility
Tools & Technologies
Client SystemsHome Internet ConnectionEthernet Connection
Certifications & Qualifications
High School DiplomaGEDCollege Degree
Industry Keywords
HealthcareMedicareCustomer ServiceRegulatory GuidelinesWorkspace Monitoring
About the role
Key responsibilities & impact- Answer a steady volume of incoming healthcare-related calls
- Assist members with Medicare enrollment, billing, claims, benefits, eligibility, invoicing, and related services
- Explain Medicare Part D, Part C Medicare Advantage, and Dual Special Need Programs (DSNP)
- Listen actively, answer questions, and make callbacks or follow-up calls as needed
- Resolve member issues and pursue one-call resolution
- Navigate member plan benefits and review client policies and procedures
- Use client-provided resources to comply with regulatory guidelines
- Utilize multiple client systems to provide accurate information
- Successfully learn and use 15–20 systems
- Handle an average of 30–40 calls per day
- Multitask and apply problem-solving skills while maintaining courteous service
Requirements
What you’ll need- Minimum 6 months of customer service experience
- High school diploma, GED, or college degree
- Successfully complete a customer service assessment and computer typing test
- Complete mandatory paid training with 100% attendance
- Successful completion of a background check
- Flexible availability during operating hours of 7:45 a.m.–11:00 p.m. EST Monday–Saturday and 7:45 a.m.–8:00 p.m. EST Sunday
- Home internet connection with at least 25 Mbps download and 10 Mbps upload speed
- Ability to hardwire the work computer to the home modem via Ethernet
- Satellite and wireless internet are not acceptable
- Quiet, distraction-free, clutter-free workspace with no other people, writing utensils, or unauthorized electronics during working hours
- Must comply with continued workspace monitoring
- Must reside in an eligible US state or municipality where the compensation structure complies with applicable wage regulations
- Not currently hiring in AK, CA, CT, HI, IL, MA, MD, MT, NJ, NY, OR, WA, Minneapolis–MN, Washington, DC, or Denver/County of Boulder/Edgewater County–CO
Benefits
Comp & perks- Paid time off accrued after 180 days of employment
- Medical, dental, and vision benefits available on the 1st day of employment
- Mandatory paid training program
- Employer-provided equipment: computer, monitor, mouse, keyboard, headset, Ethernet cord, and power cables
- Potential bonus or incentive based on business need
- Health insurance coverage
- Voluntary dental and vision programs
- Life and disability insurance
- Retirement savings plan
- Paid holidays
- Paid time off (PTO) or vacation and/or sick time
- Career growth opportunities within the healthcare team