Health Plan Specialist - Medicaid

About the Role

We are working with a prominent Minnesota-based nonprofit health plan organization that supports members enrolled in Medicaid, Medicare, and commercial insurance programs. Known for its dedication to members and enhancing community health, this client is currently seeking a Health Plan Specialist dedicated to Medicaid to join their member services team during an intense and busy period.

Job Description

This fully remote, phone-based position involves being the initial point of contact for members who have detailed inquiries concerning their benefits, billing issues, and enrollment processes. Specialists handle approximately 50 to 70 calls daily during the peak Open Enrollment period, providing comprehensive resolutions while maintaining detailed documentation to ensure timely and accurate outcomes.

Key Responsibilities

• Deliver respectful and courteous service, always prioritizing the customer’s perspective
• Efficiently use available online tools and resources to manage inquiries
• Accurately resolve customer issues with timely follow-ups
• Professionally and empathetically assist members facing complex situations

Shift and Training Requirements

• Flexible availability to work any shifts between 8:00 AM and 6:00 PM CST, Monday through Friday (no weekend shifts)
• Four weeks of virtual classroom training daily from 8:00 AM to 4:30 PM
• Two weeks of on-the-job training during scheduled hours
• Training conducted virtually via Teams, including live sessions, interactive modules, breakout rooms, quizzes, and team building; active camera use required

Remote Work Requirements

• Hard-wired Ethernet internet connection with stable high-speed access required; Wi-Fi, satellite, or hotspots are not acceptable
• Must pass speed tests as stipulated by the client
• Ability to maintain a professional, distraction-free workspace
• Camera usage mandatory for all meetings and training sessions
• Must utilize provided equipment including headset and dual monitors

Qualifications

• High School Diploma, GED, or equivalent (experience may substitute education)
• At least two years of call center experience
• Customer service experience in health insurance is strongly preferred
• Proficiency in Microsoft Office and comfortable managing multiple screens and applications simultaneously
• Strong verbal and written communication skills
• Demonstrated commitment to excellent attendance
• Excellent critical thinking with empathy and problem-solving skills
• Enthusiasm to progress and develop professionally within the organization
• Team collaboration skills and supportive attitude toward colleagues
• Positive demeanor focusing on enhancing member experiences

Additional Information

Location Requirement: Must have a primary residence in one of the following states: Arkansas, Arizona, Florida, Georgia, Iowa, Illinois, Kansas, Kentucky, Michigan, Minnesota, Missouri, North Dakota, Nebraska, Oklahoma, South Dakota, Tennessee, Virginia, or Wisconsin.

Compensation

The position offers an hourly wage of $21.

Benefits

The employer offers a comprehensive benefits package that provides eligible workers with options tailored to meet family needs.

Equal Opportunity Statement

The company is committed to diversity and inclusion, welcoming applicants from all backgrounds and experiences.