Medicare Complaints & Data Entry Coordinator

Qlarant; Easton (MD); On-site; USD 36,000 - 52,000; Full time

Job summary

Qlarant is seeking a qualified candidate to handle Medicare Advantage and Prescription Drug complaint cases. The role involves interviewing complainants, researching subjects, and determining disposition with close supervision.

Responsibilities include communicating with beneficiaries, plans, pharmacies, and providers to resolve issues, performing data entry, and preparing findings for Level II review while handling confidential information.

Qualifications

• Minimum High School Diploma or GED.
• 0-2 years of experience required; 2-4 years preferred.
• Call Center experience preferred.
• Data Entry experience preferred.
• Healthcare or Medicare experience preferred.

Responsibilities

• Communicates with beneficiaries, plans, pharmacies, and providers as needed to resolve complaints.
• Evaluates the facts of a complaint and researches additional information as necessary.
• Compiles findings and determines if appropriate for closure or presentation to Level II team.
• Handles a wide variety of confidential situations.
• Performs data entry of complaints into the case management system and a variety of other databases.
• Performs minor background research on subjects of interest as required for the screening of complaints.
• Prepares appropriate letter templates and/or revises the content based on the facts presented in the complaint.
• Communicates with external customers including beneficiary or individual complainants, representatives from the Senior Medicare Patrol, Plan Sponsors, CMS, and others.

Skills

Call Center experience

Data Entry

Healthcare/Medicare experience

Communication skills

Education

High School Diploma or GED

Job description

Qlarant is seeking a qualified candidate to handle Medicare Advantage and Prescription Drug complaint cases. The role involves interviewing complainants, researching subjects, and determining disposition with close supervision.

Responsibilities include communicating with beneficiaries, plans, pharmacies, and providers to resolve issues, performing data entry, and preparing findings for Level II review while handling confidential information.