Senior Medicare Complaints Specialist

Employer Industry: Healthcare Services

• Salary up to $30 per hour
• Generous paid time off and employer-sponsored health, dental, and vision plans
• $100 monthly mobile or internet stipend
• Bonus eligibility for all roles excluding Director and above
• Opportunity to contribute to meaningful healthcare improvements for older Americans
• Work in a supportive and diverse environment with a commitment to treating members like family

• Research and resolve Medicare‑submitted complaints in accordance with CMS guidelines and internal SOPs
• Communicate with members via phone, email, and written correspondence to resolve complaints
• Handle complex or highly escalated cases with professionalism and empathy
• Conduct root cause analyses and help categorize complaints appropriately
• Document all complaint activity with accuracy across multiple systems and platforms

• Minimum of 3 years of experience in Medicare Advantage, with a focus on complaints, appeals, or grievances
• Familiarity with CMS Chapter 2 and Chapter 3 guidelines
• Excellent customer service and conflict resolution skills
• Strong written and verbal communication skills
• Ability to work both independently and collaboratively in a fast‑paced environment

• Bachelor’s degree or equivalent experience in healthcare, conflict resolution, or a related field
• Experience working directly with CMS submissions and CTM documentation
• Knowledge of health insurance products and claims processing
• Familiarity with RCA methodologies and reporting best practices
• Experience mentoring peers or participating in training initiatives

#Healthcare Services #Medicare Advantage #Customer Service #Career Opportunity #Diversity And Inclusion

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