Member Services Representative - Medicare Advantage

MEDICARE ADVANTAGE MEMBER SERVICES REPRESENTATIVE

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).

Location:

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

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 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.

• 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.

• 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.