Medicare Advantage Member Services Specialist

BrightSpring Health Services; Louisville (KY); On-site; USD 42,000 - 70,000; Full time

Job summary

Abilis Health Plan, affiliated with BrightSpring Health Services, seeks a Member Services Analyst to serve as the primary contact for enrollment, benefits information, and inquiries related to Medicare Advantage and SNP operations.

You will collaborate with interdisciplinary teams, manage member interactions, and ensure timely resolutions while maintaining CMS compliance and patient privacy expectations.

Qualifications

• 2+ years in healthcare member services or health plan operations.
• Experience with Medicare Advantage or managed care preferred.
• Ability to explain benefits in plain language.

Responsibilities

• Provide accurate information on Medicare Advantage benefits and enrollment.
• Process inquiries, enrollments, claims, and authorizations per CMS timelines.
• Maintain records in CRM and ensure HIPAA-compliant handling of PHI.
• Coordinate with care teams, providers, and internal departments.
• Educate members on ANOC/EOC distributions and plan changes.

Skills

CRM systems

Communication skills

Regulatory compliance

HIPAA knowledge

Microsoft Office

Patient/customer service

Education

Bachelor's or Associate's degree in Healthcare Administration / Social Work / related field

Tools

EHR systems

CRM software

CMS training tools

Job description

Abilis Health Plan, affiliated with BrightSpring Health Services, seeks a Member Services Analyst to serve as the primary contact for enrollment, benefits information, and inquiries related to Medicare Advantage and SNP operations.

You will collaborate with interdisciplinary teams, manage member interactions, and ensure timely resolutions while maintaining CMS compliance and patient privacy expectations.