Humana logo
Humana

Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off

Medicare Call Center Representative - Inbound Contacts Representative II

Location

United States

Posted

21 hours ago

Salary

$19 - $20 / hour

Seniority

Senior

Associate Degree

Job Description

Medicare Call Center Representative - Inbound Contacts Representative II

Humana

Title: Medicare Call Center Representative - Inbound Contacts Representative II Location: United States Work Type: Remote, Full Time Job ID:414348 Job Description: Become a part of our caring community The Medicare Call Center Rep (Inbound Contacts Representative 2) represents Humana by addressing incoming telephone, digital, or written inquiries. The Medicare Call Center Rep performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. In this position, you will strive to provide our Group or Individual Medicare members with a resolution or pathway to resolution on each call, while providing a perfect call experience. Among other responsibilities, you will address member needs which may include complex benefits questions, resolving issues, and educating our members. - You will handle 40+ inbound calls daily from our members in a fast-paced inbound call center environment. This is a high-volume call center setting, which may be stressful at times. - You will accurately record details of inquiries, comments or complaints, transactions or interactions, and take prompt / appropriate action, including escalating unresolved and pending member grievances. - Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. - You will work under minimal direction within defined parameters to identify work expectations and quality standards but will have some latitude over prioritization / timing. - You will follow standard policies / practices that allow some opportunity for interpretation / deviation and / or independent discretion. Use your skills to make an impact Required Work Schedule: - Virtual training will start on day one of employment and runs for the first 12 weeks with a schedule of 8:00 AM to 4:30 PM EST, Monday through Friday. - You must be on time, dressed appropriately, with your camera ON for the entire duration of training and for other meetings required by leadership. Your entire face, from the shoulders up, must be clearly visible with no obstructions. - Attendance is vital for success, so no time off is allowed during training. Exception: Should a Humana-observed holiday occur during training or within the initial 120-days of employment, you will have the holiday off (paid). - All associates are subject to a 180-day appraisal period. - Following training, you will be assigned to an 8-hour shift between the hours of 8:00 AM and 8:00 PM Eastern Time, Monday through Friday. - Shift Bids take place periodically and are based on performance and business needs. - Some weekends and overtime may also be required, especially during our peak season of October through March and as needed by the business. No time off is allowed in January of each year (except Humana-observed holidays). We strive to provide a minimum of a week's advance notice for required weekends and / or overtime; however, at times business needs do not allow for a week's advance notice. - This opportunity involves working in a call center environment to support Humana Medicare members. As part of your career development for this position, you may be asked to assist with other lines of business. This will be based on business requirements and may include Member Solutions, which handles escalations. - Humana strongly supports your career growth! All Humana positions require learning many systems, policies, and tools, and it takes time to become proficient in the role. All associates who wish to apply for positions must have been in their present position for a period of twelve (12) months, unless the best interests of the company are served by a shorter period of service. Required Qualifications - You must have a minimum of 2 years of customer service experience - You must have demonstrated experience with providing strong customer service, using effective communications skills and strong attention to detail, while also actively listening to their needs - You must have prior experience managing multiple or competing priorities, including use of multiple computer applications and systems simultaneously - You must be proficient with Microsoft Office applications, particularly Outlook and Teams Preferred Qualifications - Previous inbound call center or related customer service experience - Previous healthcare experience - Associate or Bachelor's degree - Bilingual in Spanish and English (see Language Proficiency Testing below) Pay Rate - IMPORTANT: While you see an estimated pay range reflected in this job posting, the pay rate for this position is $19.24 per hour ($20.24 for Spanish / English Bilingual; requires language proficiency testing) and is non-negotiable. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended (you can check your speed at speedtest.net). - Associates in this role are required to be hard-wired to their internet connection. Wireless, satellite, cellular and microwave connections are NOT permitted. - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided with a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - You must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Language Proficiency Testing Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Note: Depending on the number of openings, the number of candidates who apply, and the schedules of interviewers and recruiters, this process may take several weeks or less; however, know that we are working hard to proceed as quickly as possible and to keep you informed. Travel: While this is a remote position, occasional travel to Humana''s offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $39,000 - $49,400 per year 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.

Related Categories

Related Job Pages

More Call Center Representative Jobs

Covisian Perú logo

Call Center Advisor

Covisian Perú

Como importante multinacional seguimos en crecimiento.

Role Description Únete a uno de los mejores lugares para trabajar en Perú, puesto 16° del GPTW, líderes en servicios de Call Center. Actualmente estamos en búsqueda de: - ASESORES TELEFÓNICO DE VENTAS Disponibilidad: DE LUNES A SÁBADO DE 9AM a 6PM Descanso: DOMINGO Modalidad de trabajo: REMOTO Qualifications - Con o sin experiencia laboral previa en el rubro. - Actitud y ganas de tener un trabajo estable. - Manejo de computadora a nivel usuario. Benefits - Ingreso a planilla completa desde el primer día de trabajo con todos los beneficios de ley (gratificaciones, CTS, utilidades, vacaciones pagadas, asignación familiar, EsSalud, etc.). - Básico S/1130 + Comisiones atractivas S/800 a más + S/113 A-F + BONO DE LUZ + PLANILLA COMPLETA - Capacitaciones CORTA Y REMUNERADAS desde el primer día. - Convenios educativos con universidades, institutos. - Descuentos corporativos para servicios de entretenimiento, restaurantes, entre otros. Company Description

Peru
800 - 1.1K / year
State of Oregon logo

IT Call Center Supervisor

State of Oregon

The State of Oregon was the 33rd American territory inducted into the United States in 1859. Nicknamed the "Beaver State" after its official state animal and it

Title: IT Call Center Supervisor Location: Milwaukie =United States time type Full time job requisition id REQ-201794 Agency: Oregon Liquor & Cannabis Commission Salary Range: $6,834 - $10,569 Position Type: Employee Position Title: IT Call Center Supervisor Job Description: The Oregon Liquor and Cannabis Commission (OLCC) oversees access to alcohol and cannabis products in Oregon through education, regulation, and distilled spirits distribution. Our aim is to protect public health and safety while supporting responsible businesses and providing funding for local and state agencies. This position manages the Commission’s external-facing Call Center. In collaboration with the CIO and IT managers, this position participates in strategic planning and solutions roadmap and provides direction, planning, and policy development within the division. It provides effective development, implementation and management of the call center to ensure access to OLCC public facing applications for customers. This position manages relationships with staff administrative contacts, vendors, business partners, and other state agencies to understand, develop, manage, and communicate OLCC IT operations and their impact to the Recreational Marijuana, Distilled Spirits, and/or Public Safety Divisions for the State of Oregon, including impacts on the public, other agencies and private sector businesses regulated by the Commission. What’s in it for you: - Rewarding work in a productive and creative environment - Colleagues who are passionate about public service and safety - Work/life balance, 11 paid holidays a year, personal days, sick time, vacation accruals, and more! Click here to learn about State of Oregon benefits. - Pension and retirement programs - Advancement and learning opportunities that will help grow your career with the State of Oregon - Possible eligibility for the Public Service Loan Forgiveness Program - A workplace that fosters fairness, equity, and inclusion to maintain a workplace environment where everyone is treated with respect and dignity. About this opportunity: - This position is based at our Milwaukie, OR headquarters office. Please note that the headquarters for the agency will relocate from Milwaukie to Portland, OR by approximately mid 2027. - After an initial training period, this position may be eligible for a flexible hybrid work schedule, however weekly in-office work will be required. This position is not eligible to be fully remote. - This position is a management service position and is not represented by a union. Here’s what you will do: - Responsible for managing, planning, organization, direction, and evaluation of the staff. - Manage the work activities of IT staff, coordinate and monitor the daily work schedule and assigning work priorities to meet planned work schedules. - Coordinate work with IT Director and CIO to assign work and provide guidance regarding agency needs and work priorities to be performed. - Verifies employees are following OLCC and DAS policies and procedures as well as abiding by Cyber Security Standards. - Ensure that employees who handle sensitive information are provided with the Security Report for their division and properly secure that information. - Provide and review the Division Security Reports with employees on a quarterly basis. - Provide information to CIO and IT management regarding division budget including agency monetary commitments. - Tracks unit expenditures and reports to communicate expenses; monitor budget anticipated vs. actual; flag budget issues with IT management and Financial Services. - Set standards and practices for Call Center, implement best practices and minimum process requirement, as well as improve Customer Service execution for quality, timeliness and accuracy. Regular and reliable attendance is an essential function of this position and is required to meet the demands of this job. Here’s what you need to qualify: Minimum Qualifications: - Four years of lead work, supervision, or progressively related experience to the class concept; OR one year of related experience and a bachelor's degree in a related field. Preferred Skills: • Experience supervising a customer‑facing technical support team or call center environment that provides Tier 1 and Tier 2 assistance across multiple systems. • Demonstrated ability to build or refine operational structures such as SOPs, workflows, support scripts, and knowledge‑base content. • Strong customer‑service sensibility, including the ability to support small business owners and the general public with patience, clarity, and empathy. • Experience onboarding, coaching, and developing staff in a service‑oriented environment, including fostering a positive and collaborative team culture. • Ability to communicate technical information in clear, accessible language to non‑technical audiences. • Skill in navigating complex organizational environments and collaborating with cross‑functional partners, vendors, and subject‑matter experts. • Experience supporting SaaS applications or other multi‑platform technology ecosystems, including the ability to learn new systems quickly. • Ability to assess call‑center performance, identify service gaps, and implement improvements in quality, timeliness, and customer satisfaction. • Strong organizational and prioritization skills, especially during periods of high call volume or system outages. • Demonstrated commitment to continuous learning, professional growth, and staying current with customer‑support best practices and modern service‑management approaches. Application instructions and information: - A resume and cover letter are required for this job posting. Please attach both in the “Resume / Cover Letter” section of the application. - Please ensure that you clearly demonstrate in your application materials that you meet the qualifications listed and that you follow all instructions carefully. Only complete applications addressed to the OLCC and received by the posted application deadline date will be considered. - You may be asked to submit a skills assessment, a writing sample, or a video/phone interview as part of the application screening process. - Internal candidates currently working for OLCC must apply using your employee Workday account. In addition to required attachments, ensure that your profile has your current job history and education. In Workday, click on Menu in the upper left corner, Jobs Hub, Find Jobs. Enter the job number in the search bar, click on the job title and select Apply. Additional information: - The use of outside resources such as artificial intelligence (AI) software during applicant skills assessments, examinations, and/or interviews is prohibited unless otherwise stated by the hiring agency. Unauthorized use of outside resources during the hiring process will result in disqualification. - The selection process consists of a review of your application and an evaluation of your education, experience, training, and overall professionalism of your application materials. Candidates that follow the application directions, submit what is required and provide us with credentials that showcase their skills and how they meet the minimum qualifications and preferred skills will be invited to an interview. Resumes will not replace the completed job history experience in Workday. We will only review documents that are requested. Because details are very important to us, your application materials will be evaluated for grammar, spelling and punctuation. - This recruitment may be used to fill current and future Permanent, Limited Duration, Job Rotation and Temporary vacancies as they occur. - Per the Pay Equity Law passed in 2017, a pay equity analysis will be conducted to determine what pay step the successful candidate will be offered. The analysis will be based on the relevant experience, education, training, and certifications documented in the application materials. On average, candidates new to state service will most likely be offered compensation in the lower to mid-level of the salary range. - Any offer of employment with OLCC is contingent on acceptable references and background check. This position requires a background and security check with fingerprinting to work in areas that handle confidential documents. An adverse background and failed security clearance will result in disqualification. - Eligible veterans who meet the qualifications will be given veterans' preference. For further information, please see the following website: Veterans Resources. NOTE: If claiming veterans’ preference please be sure to check your Workday account for pending tasks or actions under your “My Applications” section. - We hire preferred workers! For more information, please visit our website: Preferred Worker Program. - OLCC does not offer VISA sponsorships. If your employment authorization and documentation is contingent on sponsorship now or in the future, you will not meet our agency employment eligibility standards. Within three days of hire, you will be required to complete the US Department of Homeland Security's I-9 form confirming authorization to work in the United States. Helpful links and contact information: Learn more about OLCC Understanding the State Application Process Help and Support webpage OLCC is fully committed to attracting, retaining, developing, and promoting the most qualified candidates without regard to their race, gender, color, religion, sexual orientation, national origin, age, physical or mental disability, or veteran status.

Oregon
$6.8K - $10.6K / year

Billing Collection Representative

Akron Children's Hospital

Located in Akron, Ohio, the Akron Children’s Hospital has a rich history dating back to 1890 and throughout the years has grown and expanded to now being the

Resolve unpaid insurance accounts by developing relationships with payer representatives, investigating pended claims, and accurately posting resolutions to accounts, while identifying trends and maintaining provider manuals for insurance carriers.

Remote

Call Center Representative Health Plan

Presbyterian Healthcare Services

Presbyterian Healthcare Services is a nonprofit hospital system, health plan, and medical group which provides services for over 660,000 residents of New Mexico

Title: Call Center Representative Health Plan Location: New Mexico, USA Job Description: Full time job requisition id R-5570 Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $15.99 Maximum Offer $23.76 Now Hiring: Call Center Representative Health Plan Summary: Please note. This role is a work at home role available for New Mexico residents only at this time. Build your Career. Make a Difference. Presbyterian is hiring a skilled Call Center Representative to join our team. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America) Responsibilities: Responsible for providing customer service for members and providers in all PHP benefit plans. Ensure callers receive service excellence when responding to telephone, written, Pres Online, E-Business, chat and in person inquires. Some key responsibilities include - High school diploma plus one to three years office/business experience; call center experience preferred and/or is currently demonstrating customer service skills, meeting current department metric and attendance guidelines within department. - Claims processing experience in managed care with possible enrollment experience is preferred. - Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff. Written communication skills as well as business writing and presentation skills are required. - Requires strong organizational skills, ability to create, sort and analyze reports (Excel, Access, etc) and system processes. - A thorough knowledge of reimbursement methodologies i.e. DRG, Relative Value Systems, Per Diem, Fee schedule, Capitation, etc and some knowledge of risk sharing programs helpful. - Some knowledge of CRM and Facets, as well as any other databases that may be used PHS Enterprise wide. - Demonstrated ability to function effectively as a team member. Requires ability to retain plan details and basic medical terminology. - Must be able to work cooperatively with other employees and function under pressure. Demonstrated ability to sustain quality standards. Must be able to prove ability to type 30 wpm with 90% accuracy. Qualifications: - High school/GED diploma - One year office/business experience - Call Center experience preferred. All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

New Mexico
$15 - $23 / hour