HealthCare Concierge

Care N Care Insurance Company of North C; North Carolina; On-site; USD 35,000 - 55,000; Full time

Job summary

HealthTeam Advantage, a Greensboro-based health plan, is seeking a Healthcare Concierge to support Medicare members. You will handle inbound and outbound calls, address claims, enrollment and service questions, and educate members on benefits and access to care.

The role requires strong communication, problem-solving, and professional conduct with a focus on member satisfaction and retention. Knowledge of CMS guidelines and a background in managed care are preferred.

Qualifications

• Experience in customer service, sales, or account management.
• Call center/high-volume handling experience.
• Managed care or health plan operations experience.
• Strong communication and problem-solving abilities.
• Proficiency with Microsoft Office applications (Excel, Word, PowerPoint).

Responsibilities

• Handle inbound calls from members and perform proactive outbound calls as needed.
• Address member concerns related to claims, benefits, enrollment, and service issues.
• Maintain timely responses in accordance with CMS and internal metrics.
• Respond to member inquiries via email and manage member education on access to services.
• Manage member satisfaction and contribute to member retention.
• Assist in grievance and appeals processes and welcome/verification calls.

Skills

Customer service experience

Call Center experience

Interpersonal communication

Problem-solving skills

Organizational skills

Microsoft Office

Education

High School diploma

Job description

The Healthcare Concierge should have relevant customer service experience, preferably with Medicare

experience, specifically with Medicare Advantage programs, and be familiar with PPO’s and HMO’s.

Must have strong oral and written communication skills, planning and problem-solving skills, and be

skilled in personal diplomacy. The applicant must possess a high level of motivation, professionalism,

and ethical conduct and place a premium on treating others with dignity and respect.

Requirements

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Receive all inbound calls from the member population and conduct proactive outbound calls as
• assigned
• Address member concerns and answer questions related to claims issues, provider resources,
• benefits, billing, member enrollment/disenrollment, and service issues
• Resolution and timely response to all member problems within expected or required timeframes
• Adhere to set Member Services call center metrics and call evaluation requirements including,
• but not limited to set monthly call volume, call quality scores, abandonment rates, CMS service
• levels, and missed/refused call volume.
• Assist with responding to member inquiries via email
• Maintain personal metrics to established performance levels of the team
• Management of the customer relationship to ensure retention and maintain member loyalty
• Provide member education and counseling on access to services, benefits, and providers
• Assume ownership and responsibility for member satisfaction with HealthTeam Advantage
• Maintain completion of special projects, as assigned. This includes, but is not limited to member
• Assist in grievance and appeals process
• Perform verification calls for members that have enrolled in the HealthTeam Advantage plan as
• well as perform welcome calls to those members that do not require a verification call
• Perform outreach calls for members that have enrolled and require provider attestation or HRA
• completion.
• Ability to work before/past normal shift hours to complete any outstanding tasks for a member(s).
• May have to work mandatory overtime during certain timeframes in the calendar year (i.e., AEP,
• Quality Measure initiatives, other special projects)
• Ability to work either the 8:00 AM-5:00 PM, 8:30 AM-5:30 PM, 9:00 AM-6:00 PM, or 11:00
• AM-8:00 PM, Monday through Friday, outside of the Annual Enrollment Period, and the ability to be flexible with time during the Annual Enrollment Period, when Healthcare Concierge Service hours are 8:00 AM-8:00 PM, seven days a week.
• All other duties as assigned.

EDUCATION AND EXPERIENCE

Education:

• High School diploma, GED, or equivalent work experience

Required Experience:

• Customer service, sales, or account management experience
• Call Center/ High call volume handling experience
• Managed care or health plan operations experience

Preferred Experience:

• Healthcare Concierge experience

Other Requirements:

KNOWLEDGE, SKILLS, AND ABILITIES

• Call Center/Customer Service Experience
• Excellent problem-solving and organizational skills
• Strong interpersonal communication skills
• Excellent knowledge of Microsoft Office (Excel, Word, PowerPoint)
• Ability to work independently or as a team
• Operate general office equipment, including but not limited to computers, phones, and related
• devices
• Thorough knowledge of CMS guidelines, processes, and systems

PHYSICAL REQUIREMENTS

• Exerting up to 10 pounds of force occasionally (up to 1/3 of the time) and/or;
• A negligible amount of force frequently (1/3 to 2/3 of the time) to lift, carry, push, pull, or
• otherwise move objects, including the human body.
• Sedentary work involves sitting most of the time but may involve walking or standing for brief
• periods of time.
• Jobs are sedentary if walking and standing are required only occasionally and all other sedentary
• criteria are met.

ABOUT HEALTHTEAM ADVANTAGE

HEALTHTEAM ADVANTAGE is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

HealthTeam Advantage (HTA), a Greensboro-based health insurance company, owned by Cone Health, offers Medicare Advantage plans to eligible Medicare beneficiaries in 33 North Carolina counties. HTA has been certified by Best Companies Group as one of America’s Best Workplaces in 2025. To learn more about HealthTeam Advantage, visit htanc.com.