Medicare Customer Service Representative

Bloom Insurance; United States; Remote; USD 22,000 - 30,000; Full time

Benefits offered by this job

Remote work environment

Competitive compensation

Health coverage

Job summary

Bloom Insurance is seeking a Medicare Customer Service Representative to assist members with access to care, transportation, and community resources. You will handle inbound calls in a call-center style queue and schedule visits for newly enrolled members.

The role requires a high school diploma or GED and at least 6 months of Medicare healthcare customer service experience. Evening/weekend availability and a patient, empathetic approach are essential.

Qualifications

• High school diploma or GED.
• A minimum of 6 months of Medicare healthcare customer service experience required.

Responsibilities

• Serve as the first contact for members and respond in a courteous, professional manner.
• Field inbound calls and conduct outbound outreach to members.
• Provide first-call-resolution for member issues and document escalations.
• Schedule appointments, assist with prior authorization status, and explain benefits.
• Assist with replacing member ID cards and conduct health screenings when needed.
• Maintain performance metrics and document activities in provided systems.
• Respect privacy and comply with Bloom’s policies and call center standards.
• Work evenings and weekends if required.

Skills

Spanish language

Customer service

Computer skills

Active listening

Critical thinking

Multi-tasking

Communication skills

Education

High school diploma or GED

Job description

Medicare Customer Service Representative

Position Overview

Bloom, the insurance industry’s trusted growth partner is seeking an experienced and dedicated Medicare Customer Service Health. Plan We are seeking collaborative, committed, holistic, and evolving personalities. The CSR is responsible for helping members access community resources, arrange transportation, and will assist members with accessing care. The CSR conducts outreach activities to conduct initial health screening and schedules initial visits with newly enrolled members. The CSR will work in a call center-like queue responding to inbound calls from members.

We are looking for an exceptional individual who can:

• Function as the first point of contact for our client's members
• Communicate with members in a courteous, respectful, and professional manner
• Demonstrate exceptional care and compassion for our members
• Field inbound calls, as well as conduct outbound calls for member outreach
• Provide first-call- resolution for member issues
• Escalate, document unresolved issues, and reroute them to the next level of support
• Follow communication scripts and use knowledge of the company’s products and services to support member needs
• Schedule member appointments as needed, provide status updates for prior authorization, handle member claims questions, and provide the member with an explanation of benefits.
• Provide assistance with the replacement of member ID cards
• Conduct social determinates of health, and provide release assessments for members
• Maintain or exceed key performance indicators and quality performance based on established metrics
• Document all activities through appropriate systems and channels
• Empathize and remain patient with difficult callers
• Excellent attendance, along with consistent dependability and flexibility in the workplace
• Evaluate information to determine and implement the appropriate course of action to resolve the complaint and/or coordinate service recovery
• Complete required training and understand how to use tools available to recall necessary information and take appropriate action
• Consistently support Bloom’s compliance policies and maintain the privacy and confidentiality of information
• Develop an understanding of the way performance and actions affect Bloom’s Call Center performance initiatives (call handling, first call resolution, member retention, and performing proper follow-up as warranted)
• Utilize dual monitors and leverage computer-based resources to find answers to customer questions
• Must be able to work evenings and weekends, if needed
• High school diploma or GED
• 6 months of Medicare healthcare customer service required
• Perform all other duties as assigned.

Qualifications

• High school diploma or GED
• A minimum of 6 months of Medicare healthcare customer service experience required

Required Skills and Abilities

• Written and verbal fluency in Spanish language preferred
• Excellent customer service skills
• Proficient computer skills
• Active listening and soft skills
• Critical thinking skills
• Ability to multi-task in a fast-paced environment
• Self-motivator
• Excellent verbal and written communication skills
• Ability to successfully handle a high volume of inbound and outbound phone outreaches
• Ability to hold a calm, respectful tone and professional demeanor while under pressure
• Performance-driven mindset
• A solutions-minded team player
• Positive can-do attitude
• Ability to meet or exceed established call center productivity metrics
• Ability to meet or exceed established goals on all call monitoring audits
• Ability to learn and navigate through multiple different systems

What We Offer

Bloom operates with a people-first culture, which means listening to our employees to provide the benefits that mean the most to them. Our competitive compensation, comprehensive health coverage, long-term growth opportunities, and remote work environment are among the reasons that many of our employees have been with us since the beginning of our business. BeBloom our proprietary employee training and engagement program, helps you learn our business model and immerse yourself in everything our culture has to offer from day 1. From virtual live events to mentorship and leadership programs and employee-led councils, there are countless opportunities to get involved, build connections, and share your voice – because at Bloom, the real you belongs here.

Core Values

• Put People First: Uphold and promote a people-first culture within the organization, emphasizing empathy, kindness, and a commitment to making a positive difference.
• Be Stronger Together: Embrace a team player mentality, leveraging the strengths of yourself and others to collaborate as one team.
• Do What’s Right: Adhere to high ethical standards, acting with integrity to do what’s right for partners, customers, and colleagues.
• Embrace a Growth Mindset: Embrace a culture of continuous learning, education, and professional development.
• Drive Solutions: Demonstrate ingenuity and skill by sharing ideas and solutions that drive our mission forward.

About Bloom

Bloom is a third-party insurance services provider that partners with Medicare health plans to enable high-quality Medicare enrollment and drive earlier health plan activation. Founded in 2007, Bloom has partnered with national and regional payers to implement solutions for every step of the member journey, from telesales and quote & enroll to health activation outreach. Supported by its Ascend technology platform, Bloom produces closer connections and better outcomes for Medicare beneficiaries and health plan stakeholders to deliver High Value Enrollment.

Avoid Recruitment Fraud

Bloom corresponds with candidates via several communication channels including our secure online application portal. We may also correspond with candidates using email, phone call, or text message.

We interview all candidates via phone and/or Microsoft Teams. At least one interview will always precede an offer of employment. We do not send offers of employment to candidates without prior communication.

Bloom does not request confidential banking information, such as checking or savings account numbers and routing numbers, prior to an offer of employment. We will never contact a candidate or potential candidate via email, text message, social media message, Venmo, or another digital payment service to send or request money. In addition, Bloom does not ask for personal-banking access credentials, such as usernames, PIN numbers, or passwords.

We urge all candidates to avoid recruitment fraud by ensuring any and all information you provide to our company is supplied via our secure online application portal. If you are unsure whether or not you are operating on our secure platform or uncertain as to whether or not a communication you've received has come from Bloom, please reach out to [e-mail].