Member Services Representative - Medicare Advantage

A-Line Staffing Solutions LLC; Akron (OH); On-site; USD 28,000 - 31,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Life insurance

Short-term disability

401(k) with company match

On-site work

Job summary

A-Line Staffing is seeking a motivated Medicare Advantage Member Services Representative to support Medicare Advantage members via phone, provide plan education, and assist with enrollment-related tasks. This on-site role in Akron, OH is full-time and contract-based with potential for permanent hire.

This position requires compliance with CMS guidelines, strong customer service skills, and experience in health insurance.

Qualifications

• 2+ years in a call center, customer service, or health insurance support role.
• Experience working directly with Medicare beneficiaries.
• Understanding of Medicare and health insurance compliance requirements.

Responsibilities

• Handle Medicare Advantage plan changes over the phone using approved scripts.
• Document all member interactions accurately in CRM and other systems.
• Make outbound calls to members, especially during enrollment periods.
• Assist with plan education, benefits, provider networks, and plan changes.
• Ensure CMS regulations and company policies are followed during enrollment.

Skills

Call center experience

Customer service

Medicare knowledge

Education

High School Diploma or GED

Associate/Bachelor preferred

Tools

Salesforce

Job description

INTRODUCTION

A-Line Staffing is seeking a motivated and detail-oriented Medicare Advantage Member Services Representative. This role offers career growth, a supportive work environment, and full-time hours (40+ per week).

DETAILS AND COMPENSATION

Location: Akron OH 44305 - 100% on-site Payrate: $20/hr, non-licensed | $22.50/hr, licensed Required Availability: Full-Time | Monday - Friday, 8:00 AM-5:00 PM

SUMMARY AND HIGHLIGHTS

The Medicare Advantage Member Services Representative will support Medicare Advantage members through phone-based customer service, plan education, and enrollment-related activities. This role is ideal for someone with experience working with Medicare beneficiaries and health insurance, particularly in a call center or customer service environment.

This position is a contract assignment with potential to hire on permanently based upon attendance, performance, and business needs.

Benefits are available to full-time employees after 90 days of employment and include health, optical, dental, life, and short-term disability insurance. A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates.

RESPONSIBILITIES

• Complete Medicare Advantage plan changes over the phone using compliance-approved scripts.
• Accurately document all member interactions and calls.
• Make outbound calls to Medicare members as needed, particularly during Annual Enrollment Period (AEP).
• Follow up with members who may be at risk for disenrollment and participate in retention outreach programs.
• Provide personalized assistance regarding plan benefits, provider networks, pharmacy questions, and plan changes.
• Educate Medicare beneficiaries about available plan options and assist them in selecting a plan based on their needs and preferences.
• Complete plan change requests between Medicare Advantage plans.
• Assist with tracking and monitoring plan change requests and maintaining accurate reporting.
• Support presentations of plan benefit information to groups or individuals in person, as needed.
• Ensure members understand their available product and plan choices during the enrollment process.
• Maintain compliance with CMS regulations, marketing guidelines, and company policies and procedures.
• Use multiple systems simultaneously, including CRM, member documentation, plan information, website, and telephone systems.
• Perform administrative and reporting duties as assigned by management.

REQUIREMENTS

• Education: High School Diploma or GED (verifiable) | Associate's or bachelor's degree preferred.
• Attendance: Commitment to mandatory attendance during the first 90 days.
• 2+ years of experience in a call center, customer service, or support role. Must be within the health insurance industry.
• Experience working directly with Medicare beneficiaries required.
• Understanding of Medicare and health insurance compliance requirements required.
• Working knowledge of Medicare, plan design, and health insurance benefits.
• Knowledge of CMS rules and regulations related to Medicare Advantage plans.
• Ability to multitask and navigate multiple computer systems while assisting members.
• Ability to handle a moderately stressful environment and effectively calm and reassure members when needed.
• Preferred Qualifications Active health insurance license is preferred but not required.
• Experience with CRM and member documentation systems.
• Experience with Salesforce or similar customer relationship management platforms.

Training & Compliance

Selected candidates must successfully complete required plan and product training prior to the open enrollment season, including achieving a minimum 90% passing score. Candidates must be able to follow federal and state regulatory requirements, CMS marketing guidelines, and company compliance policies.