Medicare Inbound Contacts Representative - Work From Home

Buscojobs Puerto Rico; Puerto Rico; Remote; USD 28,000 - 35,000; Full time

Job summary

A healthcare service provider is seeking a Medicare Inbound Contacts Representative 2 to manage calls and inquiries from providers. The role requires strong customer service skills and attention to detail, and is ideal for those passionate about enhancing patient experiences. Flexible shifts available after training, with a focus on a remote work environment that adheres to professional standards.

Benefits

Work from home option

Paid training

Internet expense reimbursement for some states

Qualifications

• 1 year of customer service experience required.
• Demonstrated customer focus is essential.
• Strong attention to detail needed.
• Effective communication skills are important.

Responsibilities

• Handle 25+ inbound calls daily from providers.
• Record details of inquiries and act accordingly.
• Escalate unresolved customer grievances.

Skills

Customer service experience

Attention to detail

Communication skills

Typing and computer navigation

Ability to manage multiple priorities

Job description

Become a part of our caring community and help us put health first

The Provider Group Medicare Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The representative performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The Provider Group Medicare Inbound Contact Representative 2 addresses customer needs which may include answering complex benefit questions, resolving issues, and educating providers.

• Handles 25+ inbound calls daily from providers to check on members and claims in a fast-paced inbound call center environment.
• Records details of inquiries, comments or complaints, transactions, or interactions, and acts accordingly.
• Escalates unresolved and pending customer grievances. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments.
• Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
• Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Use your skills to make an impact

Training: This position is scheduled to start on December 1, 2025. Virtual training starts on day one of employment and will run for the first 8 weeks with a schedule of 8:00 am to 5:00 pm Eastern Time, Monday - Friday.

Shift: After training, you will be assigned an 8-hour shift between the hours of 8:00 am – 6:00 pm Eastern Time.

Required Qualifications

• 1 year of customer service experience
• Demonstrated customer service focus
• Strong attention to detail
• High-level of typing and computer navigation skills
• Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously
• Effective verbal and listening communication skills
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Previous inbound call center or related customer service experience
• Healthcare experience

Required Training Schedule:

• This position is scheduled to start on December 1, 2025. Virtual training starts on day one of employment and will run for the first 8 weeks with a schedule of 8:00 AM to 5:00 PM Eastern Time, Monday - Friday.
• You must be on time, dressed appropriately / camera ready, with your camera on during training and for other meetings required by leadership.
• Attendance is vital for your success; no time off will be allowed during training and limited within the first 180 days
• The initial 180 days of employment as an Inbound Contact Center Representative constitute an appraisal period. This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
• This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.

Required Work Schedule:

• Following training, associates must be able to work an 8-hour shift between the hours of 8:00 AM - 6:00 PM Eastern time, Monday - Friday. Early shifts are not a guarantee, so it is important to have availability during these hours.
• Some overtime may be required, based on business needs.

Additional Information

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Associates who live and work from Home in the state of Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Language Proficiency Testing

Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.