Medicare Call Center Rep. II, El Paso Health

Position Overview

Provides comprehensive support for Medicare Advantage (MAPD and DSNP) Members and Providers by addressing complex inquiries related to benefits, authorizations, membership, and contracts. Conducts member outreach for wellness activities, handles enrollment concerns, and supports all call center operations. Serves as a key resource for resolving Medicare-specific issues to ensure exceptional service and regulatory compliance. Assists with various call center activities and collaborates with other departments within El Paso Health (EPH) as necessary. Schedule: Works rotating hybrid shifts (remote/in-office) including weekends during the Medicare enrollment period (October 1st - March 31st) with shifts scheduled between 8am and 8pm.

Key Responsibilities

• Provide comprehensive support for Medicare Advantage Members and Providers.
• Address complex inquiries related to benefits, authorizations, membership, and contracts.
• Conduct outreach for wellness activities and handle enrollment concerns.
• Support call center operations and resolve Medicare-specific issues ensuring regulatory compliance.
• Collaborate with various departments within El Paso Health (EPH) as necessary.

Required Qualifications

• Excellent bilingual oral/written skills in English and Spanish.
• Proven customer service and communication skills.
• Strong interpersonal skills and proficiency in Microsoft Office programs.
• Computer awareness with a willingness to learn data entry.
• Ability to perform basic arithmetic (add, subtract, multiply, and divide).
• Demonstrates good oral and written communication with attention to detail.
• Two years of call center experience is required.
• Experience using management information systems to track member and provider interactions.
• Strong familiarity with Medicare, Medicaid, CHIP, or Third-Party Administration and/or social service systems.
• Must meet call center performance expectations.
• A high school diploma or equivalent is required.

Preferred Qualifications

• Associate's degree in healthcare administration or a related field is preferred.
• Knowledge of Medicare Advantage and/or DSNP plans is a plus.