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Membership Representative
Job Description
Job Title: Medicare Member Advocate
Location: Must be located in one of the following 15 states: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI
Shift: 8: 00 AM – 4: 30 PM PST
Pay Rate: $24.12 per hour
Job Description:
We are seeking a compassionate and driven Medicare Member Advocate to assist new Medicare members with their MAPD and DSNP plans. As an advocate, you will help members navigate their healthcare benefits, address concerns, and provide personal assistance during their onboarding process. Your role will be critical in ensuring that members fully understand their plan benefits and how to use them effectively.
Key Responsibilities:
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Conduct outreach to new Medicare members to provide personalized assistance with their MAPD and DSNP plans.
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Serve as the primary point of contact for members during the onboarding process, addressing questions and anticipating any potential issues.
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Develop and maintain strong relationships with members, ensuring they feel supported and informed about their benefits.
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Log all member interactions accurately in the required systems.
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Participate in regular member benefits training with the health plan.
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Ensure compliance with regulatory requirements, including CMS/DHS transmission of plan data.
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Assist with billing and reconciliation to ensure Medicare regulations are met.
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Handle special projects and assist in testing vendor systems to ensure CMS guidelines are followed.
Job Requirements
Must-Have Skills and Qualifications:
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Medicare/Medicaid background is strongly preferred.
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2+ years of experience in customer service, consumer advocacy, or healthcare systems.
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Ability to navigate multiple systems with ease.
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Strong customer service and consumer advocacy skills.
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Excellent verbal and written communication skills.
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Basic understanding of managed healthcare systems and Medicare.
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Ability to multitask and manage priorities to meet deadlines.
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Proficient in Microsoft Office applications and Medicare systems (preferably).
Education/Experience Requirements:
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High School Diploma or equivalent required.
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At least 2 years of relevant experience in customer service, consumer advocacy, or healthcare systems.
Additional Requirements:
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Dual monitors and a docking station are required for this role.
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Must maintain regular attendance and adhere to HIPAA guidelines and company policies.