Community-Focused Medicare Support Specialist

Montage Health; Monterey (CA); On-site; USD 40,000 - 50,000; Full time

Job summary

Montage Health in Monterey, CA is seeking a Customer Service Representative I to be the friendly front line for local Medicare Advantage members and healthcare partners. You will handle inbound calls and inquiries about eligibility, benefits, and claims, serving as a trusted advocate who lives in the same communities.

The role requires excellent communication, empathy, and the ability to resolve issues in a fast-paced environment.

Qualifications

• Associates degree or equivalent experience; 1–3 years in customer service or call center.
• Experience with Medicare/health plans is a plus.

Responsibilities

• Serve as primary contact for members, providers, and clients via phone, email, and in-person.
• Assist with eligibility, benefits, claims status, prior auth, and appeals.
• Provide accurate, timely, and compassionate responses to inquiries.
• Educate members and providers about benefits and next steps.
• Document communications in the system of record.
• Resolve inquiries within established timeframes.
• Coordinate appeals and grievances with internal teams.
• Support interdepartmental staff to ensure continuity of service.
• Perform other duties as assigned.

Skills

Verbal communication

Written communication

Customer service mindset

Empathy and patience

Bilingual Spanish/English

Problem solving

Education

Associate degree or equivalent experience

Tools

Microsoft Office

Job description

Montage Health in Monterey, CA is seeking a Customer Service Representative I to be the friendly front line for local Medicare Advantage members and healthcare partners. You will handle inbound calls and inquiries about eligibility, benefits, and claims, serving as a trusted advocate who lives in the same communities.

The role requires excellent communication, empathy, and the ability to resolve issues in a fast-paced environment.