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Medicare Member Services Representative
Peak Health. Take inbound calls from Peak Health Medicare Advantage members and providers .
About the role
Key responsibilities & impact- Take inbound calls from Peak Health Medicare Advantage members and providers
- Answer questions ranging from general information to complex inquiries
- Research and resolve member issues and questions with management and peers
- Make outbound calls to members and providers for issue resolution or to gather information
- Verify member information while addressing general questions
- Respond to and resolve issues and inquiries for an efficient member experience
- Conduct member outreach as required
- Handle Medicare claims processing and related inquiries
- Meet production and quality standards and maintain work queues
- Communicate with internal and external staff
- Escalate issues to the appropriate level of supervision
- Ensure accuracy of information gathered and shared on a member’s behalf
- Attend required training and demonstrate proficiency
- Maintain accurate documents, including timekeeping records
Requirements
What you’ll need- High School diploma or equivalent
- One (1) year of experience with handling Medicare claims or related experience
- Ability to sit for extended periods of time
- Ability to answer phone calls for extended periods of time
- Ability to lift 10-25 lbs.
- Ability to take direction and navigate through multiple systems simultaneously
- Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette
- Ability to solve problems with predefined methods and guidelines
- Familiarity with medical insurance services process
- Exceptional attention to detail, organization, and ability to perform multiple tasks simultaneously
- Ability to work remotely, including reliability, self-motivation, focus, and time management skills
- Willingness/ability to work an 8-hour shift between 7:30 am and 8:00 pm Monday–Friday
- Microsoft Office Professional Suite, Internet Explorer, and EPIC proficiency or familiarity