Medicare Member Services Representative

🔥 58 minutes ago

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Peak Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare Insurance • Non-profit

Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems.

📋 Description

• Take inbound calls from Peak Health Medicare Advantage members and providers answering questions ranging from general information to complex inquiries. • Make outbound calls to members and providers with issue resolution or to gather further information. • Research and resolve member issues and questions in collaboration with management and peers on the Peak team.

🎯 Requirements

• High School diploma or equivalent • One (1) year of experience with handling Medicare claims or related experience • Three (3) plus years’ experience in a fast-paced call environment with processing and/or customer service experience • Two (2) years’ experience in Medicare benefits • Two (2) years’ experience in knowledge of CMS guidelines • Experience supporting Dual Eligible Special Needs Plans (D-SNP)

🏖️ Benefits

• Health insurance • Paid time off • Opportunity for professional development