Job Information
BroadPath Healthcare Solutions Medicare Member Service Representatives in United States
Overview
BroadPath is hiring a team of work-from-home Medicare Member Service Representatives . This role is pivotal in ensuring direct and timely communication between the Plan and its members, potential members, providers, employer groups, brokers, internal departments, and external agencies. It requires a high level of knowledge about Medicare Healthcare Plans products, premiums, benefits, and procedures. The representative will use their judgment to assist callers appropriately and provide accurate problem-solving through research and resolution of concerns.
Responsibilities
Communication and Support:
Handle inquiries from members, potential members, brokers, employer groups, and other stakeholders
Verify prescription drug eligibility, benefits, claims, and authorizations
Assist members in understanding health coverage, enrollment materials, and provider networks
Document and forward member concerns, complaints, and appeals
Compliance and Documentation:
Comply with healthcare practices, policies, and ethical standards
Utilize handbooks, Evidence of Coverage, supplemental benefit information, and other resources to provide accurate information
Problem Resolution:
Identify and recommend solutions for operational problems
Maintain an organized work area and use reference materials effectively
Ensure compliance with regulatory and accreditation requirements, including DMHC, CMS, and NCQA on all calls
Project Participation:
- Work on projects assigned by the supervisor, such as new member orientation, premium billing reminders, member education, claims investigation, and more
Collaboration:
Work collaboratively with other internal departments, such as enrollments, provider inquiries, and any department to quickly resolve customer concerns or issues
Assist with premium and billing questions and process ACH and credit card payments over the phone
Qualifications
High school diploma or equivalent
Minimum 2 years of experience as Call Center Representative
Minimum 1 year of Medicare customer service or Medicare in-office experience
Strong interpersonal skills and sound judgment
Knowledge of health maintenance organizations, performance management, and customer satisfaction
Basic computer and writing skills
Preferred Experience:
Epic database experience
AA in Business or Health Care Administration
Diversity Statement
At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!
Equal Employment Opportunity/Disability/Veterans
If you need accommodation due to a disability, please email us at HR@Broad-path.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process
BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.
Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.