Membership Specialist

W3R Consulting; Illinois; On-site; USD 55,000 - 75,000; Full time

Job summary

W3R Consulting in Illinois seeks an experienced enrollment operations specialist focused on Medicare Advantage. You will manage escalations, CMS complaints, and grievances while ensuring adherence to CMS guidelines.

The role includes some daily outbound member calls to support issue resolution and case follow-up, with a strong emphasis on clear communication and customer service. You will work with cross-functional teams to resolve complex member issues and improve enrollment processes.

Qualifications

• Experience with Medicare Advantage enrollment operations.
• Ability to manage escalations, CMS complaints, and grievances following CMS guidelines.
• Strong communication and customer service skills.

Responsibilities

• Occasional outbound member calls to support issue resolution and case follow-up.
• Primarily focused on enrollment operations and resolving complex member issues.

Skills

Medicare Advantage

Escalation management

CMS guidelines

Customer service

Communication

Problem solving

Job description

Description:

The ideal candidate will have experience in Medicare Advantage enrollment operations and a proven ability to manage escalations, CMS complaints, and grievances while adhering to CMS guidelines. This role includes some daily outbound member calls to support issue resolution and case follow-up but is primarily focused on enrollment operations and resolving complex member issues. Strong communication, problem-solving, and customer service skills are required