Medicare Outreach Inquiry Specialist
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.
The Medicare Member Outreach Specialist retrieves and respond to daily messages left on the After-Hours Medicare Member Help Team (MHT) voicemail.
Responsibilities include, but are not limited to:
- Retrieve and respond to daily messages left on the After-Hours Medicare Member Help Team (MHT) voicemail.
- Retrieve and reconcile the Late Enrollment Discrepancy report followed by outbound member calls to obtain attestations of prior creditable coverage
- Complete proactive member outbound campaigns and ad hoc outreach calls as assigned
- Review and assess Medicare Advantage (MA) and Medigap member email inquiries to meet the NCQA turnaround time
- Support the Medicare Inquiry Specialists by monitoring the legislative phone line as needed
- Serve as the members’ advocate and point of contact during ongoing investigations
- Investigate assigned escalated issues in a thorough and timely manner
- Identify trends and recommend possible solutions.
- Expeditiously route misdirected inquiries to the appropriate area.
- Assist the MHT by servicing inbound calls based on service levels.
- Close the Loop in all interactions.
- Required to work overtime and some company holidays based on business need.
- Perform other duties as assigned.
Qualifications
- Bachelor's degree or equivalent operations experience
- Insurance License a plus
- Develop and maintain positive working relationships with internal and external resources.
- Excellent oral and written communication skills, as well as a strong attention to detail
- Possess above average problem solving and follow-up skills
- Demonstrated ability to work independently with minimal supervision
- Sense of urgency and ability to prioritize multiple assignments with overlapping timeframes
- Prior MHT experience preferred, or training will be required
- Proficiency with Microsoft Access and Excel is preferred
Hybrid:
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Diversity, Equity, and Inclusion
At AmeriHealth, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At AmeriHealth, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
AmeriHealth is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.