Customer Service Representative, Medicare Advantage – Remote Full Time

Summary:

McLaren Integrated HMO Group, a fully owned subsidiary of McLaren Health Care, is hiring a Customer Service Representative for its Medicare Advantage division. The role involves assisting members with various services, educating them, and providing problem-solving solutions. This is a fully remote position offering the chance to be part of a dynamic healthcare organization that values employee contributions and promotes a high-performance culture.

Responsibilities:

• Handle daily member telephone calls, directing members to the appropriate services.
• Educate members and resolve any inquiries or issues they may have.
• Create linkages to the Medical Management Department for authorization of services.
• Assist providers with eligibility, benefit, and claims issue resolutions.
• Support the Medicare population with healthcare-related inquiries.

Requirements:

• High School Diploma or equivalent certification.
• One (1) year experience in a customer service-related role with direct contact with customers via telephone, email, chat, and/or face-to-face.
• Preferred: One (1) year experience in a physician healthcare office environment or high-volume call center.
• Preferred: One (1) year experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions.

Benefits:

• Health insurance.

Tagged as: Customer Service, Healthcare, McLaren Integrated HMO Group, United States