Humana Medicare Membership Retention Specialist-- NEW YORK CITY

Profile

Description

The Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area, including but not limited to mobile touch point locations in the various markets. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment

Responsibilities

The Consumer Service Representative 3 will focus on membership retention of current and new members by providing local proactive 'high touch' outreach and enhanced member experience. This role includes functions relative to benefits, enrollment and eligibility, member support, claims interpretation and processing, agent support, onboarding, local agency outreach, billing issues, payments, provider questions and call center operations. The Representative will regularly exercise discretion and judgment in prioritizing requests, interpreting and adapting procedures, processes and techniques.

The Consumer Service Representative 3 will work alongside a Sales Manager in a specific market by making outbound calls and proactively managing potential member dissatisfaction. The associate will focus on membership retention of current and new members by providing local proactive customer service as it relates to members plan i.e. benefits, enrollment, eligibility, billing issues, payments, provider questions. Associate will be responsible for making outbound calls as well as having the flexibility to work alongside with local sales agents and leaders.

Contact provider office

Contact Pharmacy

Handling of escalated issues

Communication

Interaction with peers, sale agents and leadership- Collaboration and resolution

Representatives must document and track all interactions based upon CMS guidelines, participate in interdepartmental discussions and planning and assist the Enterprise Test and Learn Committee in measuring retention impact.

Work Location : Specialists should live and work in the respective Market.

Required Qualification

2 years of customer service experience, preferably in a role focused on customer retention and resolving/preventing customer issues.

Previous inbound and/or outbound call center or related customer service experience

Excellent verbal, listening and written communication skills

Aptitude for quickly learning and navigating new technology, systems and applications

Proficient in Microsoft Office Outlook and Word

Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems

Bilingual- Spanish

Preferred Qualifications

Required Qualification

2 years of customer service experience, preferably in a role focused on customer retention and resolving/preventing customer issues.

Previous inbound and/or outbound call center or related customer service experience

Excellent verbal, listening and written communication skills

Aptitude for quickly learning and navigating new technology, systems and applications

Proficient in Microsoft Office Outlook and Word

Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems

Bilingual- Spanish

Preferred Qualifications

Associate's or Bachelor's Degree

Healthcare experience and/or sales or business development

Clerical support background in a healthcare environment

Familiarity with medical terminology

Medicare experience strongly preferred

Scheduled Weekly Hours

40

New York City Pay Range

The compensation range represents a good-faith estimate of starting pay at the time of posting and may vary based on geographic location and/or employment type. Individual pay decisions will vary based on demonstrated job-related skills such as education, experience, certifications, etc.

43,500-59,925

Pay Type

Hourly

Incentive

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Company info

Humana Inc.
Website : http://www.humana.com