Medicare Member Engagement Representative - Seasonal

Summa Western Reserve Hospital•Akron, OH

31d•$16 - $25•Onsite

About The Position

Completes Medicare Advantage plan changes over the phone utilizing a compliance approved script. Documents all calls. Tracks and follows-up with SummaCare Medicare members at risk for disenrollment from the health plan. Assists with outreach programs designed to increase retention of SummaCare Medicare members. Acts as support when presenting plan benefit information to groups or individuals in person, as needed. Complies with Center for Medicare and Medicaid Services (CMS) rules and regulations related to Medicare Advantage plans.

Requirements

High School Diploma or GED
One (1) year experience in a call center, customer service, or support role in the health insurance industry performing same or similar responsibilities which includes any combination of the following:
Customer service experience dealing with Medicare beneficiaries,
Understanding of Medicare / health insurance compliance
Working knowledge of Medicare, plan design and benefits
Possess working knowledge of Center for Medicare and Medicaid Services (CMS) rules and regulations related to Medicare Advantage plans
Ability to complete SummaCare plan and product training prior to open enrollment season with a passing rate of 90%.
Ability to multi-task. Operate computer, MACESS member documentation system, Plan Central, Salesforce CRM system, utilize SummaCare website and phone system while speaking and collecting information from member and when applicable prospective enrollee.
Excellent phone skills.
Strong understanding of Federal and State regulatory requirements and Marketing Guidelines.
Able to work independently and within a team environment.
Effective listening and critical thinking skills.
Ability to develop, prioritize and accomplish goals.
Demonstrate time management.
Moderate Complexity: Independent judgment, decision-making, problem solving related to programs and projects, technical systems; interpreting policies and procedures within and across departments.
Moderate Stress: Variety of work that is complex in nature; requires attention to detail; frequent interruptions and distractions; involves coordinating across departments. Accountable for personal performance and completion of projects across departments. Frequently required to calm and gain confidence of others.
Ability to travel from location to location throughout the workday.
Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity
Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.

Nice To Haves

Associate's or BA/BS preferred
Two (2) years of experience in the health insurance industry strongly preferred

Responsibilities

Completes Medicare Advantage plan changes over the phone utilizing a compliance approved script.
Documents all calls.
Tracks and follows-up with SummaCare Medicare members at risk for disenrollment from the health plan.
Assists with outreach programs designed to increase retention of SummaCare Medicare members.
Acts as support when presenting plan benefit information to groups or individuals in person, as needed.
Complies with Center for Medicare and Medicaid Services (CMS) rules and regulations related to Medicare Advantage plans.