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.

• 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
• Adhere to guidelines for MA Plans as required by the Centers for Medicare and Medicaid Services (CMS).
• 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.

• Bachelor's degree or equivalent operations experience
• Minimum 3 years of related experience
• Insurance License a plus
• Effective educator with knowledge and understanding of Medicare, MA and Medigap benefits
• Effective listening and empathy skills, and ability to assess and address member needs while providing the appropriate member experience.
• Maintains a high level of customer focus through the Independence Customer Service Principles in all interactions.
• Demonstrated experience dealing effectively with both calm and irate members and/or their representative(s).
• 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
• Ability to work from home in accordance with the teamwork from home policy.

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.