Medicare Advantage Member Support Lead (Remote)

Mass General Brigham Health Plan, Inc.; Somerville (MA); On-site; USD 30,000 - 44,000; Full time

Job summary

Mass General Brigham Health Plan Holding Company, Inc. is seeking a Medicare customer service professional to handle inquiries, resolve concerns, and guide members on benefits, claims, billing, and enrollment via phone, email, and in-person interactions.

The role emphasizes documenting interactions, collaborating with billing and care teams, educating members on preventive services, and meeting performance metrics while maintaining HIPAA confidentiality.

Qualifications

• High School Diploma or Equivalent required; Associate degree preferred.
• 1–2 years in Customer Service, preferably in healthcare, insurance, or call center.
• Experience with Medicare beneficiaries, healthcare billing, or insurance plans preferred.
• Familiar with CRM, EHR systems, or call tracking software.

Responsibilities

• Respond to inbound calls, emails, and inquiries from Medicare members and caregivers.
• Explain plan benefits and access to services within the network.
• Document all member interactions in service/call center systems.
• Collaborate with billing, care management, and clinical teams to resolve issues.
• Educate members on preventive services, scheduling, and care navigation.
• Follow scripts, protocols, and CMS regulations for compliance.
• Maintain HIPAA confidentiality and protect patient information.
• Identify recurring issues and escalate trends to leadership.
• Meet performance and quality metrics (volume, response time, CSAT).

Skills

Customer service

Medicare knowledge

Communication skills

MS Office

CRM software

Call center experience

Education

High School Diploma or Equivalent

Associate's Degree Healthcare Administration preferred

Associate's Degree Business preferred

Associate's Degree Related Field of Study preferred

Tools

CRM software

EHR systems

Call tracking software

Microsoft Office

Job description

Mass General Brigham Health Plan Holding Company, Inc. is seeking a Medicare customer service professional to handle inquiries, resolve concerns, and guide members on benefits, claims, billing, and enrollment via phone, email, and in-person interactions.

The role emphasizes documenting interactions, collaborating with billing and care teams, educating members on preventive services, and meeting performance metrics while maintaining HIPAA confidentiality.