Medicare Retention Specialist

Solis Health Plans

15h • Onsite

About The Position

The Medicare Retention Specialist is responsible for supporting member retention efforts by providing exceptional customer service to Medicare Advantage members. This role focuses on addressing member concerns, resolving issues, and educating members on plan benefits to improve satisfaction and reduce voluntary disenrollment.

This is an entry-level position ideal for candidates interested in healthcare, insurance, or customer service careers.

Position is onsite. Schedule is Monday – Friday from 8:00 AM – 5:00 PM

Requirements

• High school diploma or equivalent required
• 1-2 years of experience in customer service, call center, or healthcare environment required
• Bilingual (English/Spanish) required
• Strong verbal and written communication and problem-solving skills
• Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new systems quickly.
• Ability to handle sensitive situations with empathy and professionalism
• High level of professionalism and ability to handle confidential information

Nice To Haves

• Experience working with Medicare or health insurance plans
• Knowledge of CMS regulations (a plus, not required)
• Prior experience in retention efforts

Responsibilities

• Respond to inbound and outbound calls from Medicare members regarding plan questions, concerns, and potential disenrollment requests
• Identify at-risk members and take proactive steps to improve retention
• Educate members on plan benefits, coverage, and available resources
• Resolve member issues related to claims, billing, pharmacy, and provider access
• Document all interactions accurately in the system in compliance with CMS guidelines
• Collaborate with internal departments (claims, enrollment, provider relations) to resolve escalated member issues
• Follow all compliance and regulatory requirements related to Medicare Advantage plans
• Meet performance metrics such as call quality, productivity, and retention goals

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED