Medicare Member Experience Specialist

Apex Systems; Akron, Northern (OH, KY); Hybrid; USD 38,000 - 54,000; Full time

Job summary

Apex Systems is seeking a Medicare Member Engagement Representative to serve as the primary contact for beneficiaries, guiding health plan choices and enrollment changes while ensuring compliant service.

In this on-site Ohio role, you will educate members on plan options, document interactions in CRM, process enrollments, and collaborate with internal teams to resolve concerns and support retention.

Qualifications

• High School Diploma or GED required.
• Associate's degree or Bachelor's degree preferred.
• Minimum of two (2) years of experience in a call center, customer service, or support role within the health insurance industry.
• Experience working directly with Medicare beneficiaries is required.
• Strong understanding of Medicare regulations, health insurance compliance, and Medicare plan benefits.
• Previous healthcare or health insurance industry experience strongly preferred.

Responsibilities

• Assist Medicare beneficiaries with health plan selections, enrollment changes, and benefit-related inquiries using approved guidelines.
• Provide personalized support regarding plan benefits, provider networks, pharmacy coverage, and enrollment options.
• Conduct inbound and outbound member outreach to communicate plan updates, coverage changes, and enrollment opportunities.
• Support member retention initiatives through proactive follow-up and engagement activities.
• Educate members and prospective enrollees on Medicare plan options and benefits.
• Document member interactions in CRM and member management systems.
• Process enrollment transactions and plan changes per established procedures.
• Track enrollment activities to ensure timely completion and accuracy.
• Maintain CMS regulations and company policies compliance.
• Assist with reporting, admin tasks, and database maintenance.
• Collaborate with internal departments to resolve member concerns and deliver positive experience.

Skills

CMS regulations

Customer service

Phone skills

Listening

Problem-solving

Multitasking

CRM platforms

Enrollment systems

MS Office

Team collaboration

Education

High School Diploma or GED

Associate's degree preferred

Bachelor's degree preferred

Tools

CRM systems

Enrollment platforms

MS Office

Job description

Apex Systems is seeking a Medicare Member Engagement Representative to serve as the primary contact for beneficiaries, guiding health plan choices and enrollment changes while ensuring compliant service.

In this on-site Ohio role, you will educate members on plan options, document interactions in CRM, process enrollments, and collaborate with internal teams to resolve concerns and support retention.