Medicare Advantage Customer Service Team Lead

Location: Northern

## Medicare Advantage Customer Service Team Lead Apply:
Remote:
Somerville-MA:
Full time:
Posted Today:
RQ4080536

Site:
Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
** Job Summary
** Responsible for providing exceptional customer service to Medicare beneficiaries by handling inquiries, resolving concerns, and offering guidance on benefits, claims, billing, and enrollment. This role supports patients and members within a healthcare organization through phone-based, email, and in-person interactions, and plays a key role in ensuring a positive member experience.
Essential Functions  
-Respond to inbound calls, emails, and inquiries from Medicare members, family members, and caregivers regarding coverage, eligibility, claims, and billing.
-Assist members in understanding their Medicare plan benefits and how to access services within the healthcare network.
-Document all member interactions accurately in customer service or call center systems.
-Collaborate with departments such as billing, care management, and clinical teams to resolve complex member issues or escalations.
-Educate members on preventive services, appointment scheduling, and care navigation resources.
-Follow scripts, protocols, and compliance guidelines in accordance with Medicare and CMS regulations.
-Maintain confidentiality and protect patient/member information per HIPAA guidelines.
-Identify recurring concerns or patterns and escalate trends to leadership to improve processes.
-Meet performance and quality metrics such as call volume, response time, and customer satisfaction scores.
** Qualifications
* * Education  High School Diploma or Equivalent required and Associate's Degree Healthcare Administration preferred or Associate's Degree Business preferred or Associate's Degree Related Field of Study preferred    Experience  - Experience in Customer Service, preferably in a healthcare, insurance, or call center setting 1-2 years required
- Experience working with Medicare beneficiaries, healthcare billing, or insurance plans 0-1 year preferred or

Experience with CRM, call center software, or electronic health records (EHR) systems 0-1 year preferred
- Experience working with DSNP preferred    Knowledge,

Skills and Abilities

- Strong understanding of Medicare benefits, claims processes, and CMS guidelines.
- Excellent verbal and written communication skills.
- Ability to remain calm and empathetic when dealing with frustrated or confused members.
- Strong attention to detail, accuracy, and documentation.
- Ability to multitask in a high-volume, fast-paced call center environment.
- Proficient in Microsoft Office and call tracking software.
** Additional Job Details (if applicable)*
* • M-F 8:30AM - 5PM EST business hours required for remote role
• A quiet, secure, stable, HIPPA-compliant workstation is required.  
** Remote Type
** Remote
* * Work Location
** 399 Revolution Drive
** Scheduled Weekly Hours
** 40
* * Employee Type
** Regular
* * Work Shift
** Evening (United States of America)
** Pay Range**$22.22 - $31.71/Hourly
** Grade
* * 4

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your…