Medicare Member Advocate I

Medicare Member Advocate I

Location: Birmingham, AL

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

• Hourly pay starting at $17.00 and up


• Strong incentive plan with an average of $7000/year (start earning as quickly as your 3rd month!)


• Comprehensive Health, Vision, and Dental Coverage


• 401(k) Savings Plan with company match and immediate vesting


• Paid Time Off (PTO)


• 9 Paid Holidays annually plus a Floating Holiday to use as you choose


• Tuition Assistance


• Flexible Spending Accounts


• Healthcare Reimbursement Account


• Paid Parental Leave


• Community Service Time Off


• Life Insurance and Disability Coverage


• Employee Wellness Program


• Training and Development Programs to develop new skills and reach career goals


• Employee Assistance Program

See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

Job Description

The Medicare Member Advocate I will assist members with questions and issues related to their coverage with VIVA MEDICARE – primarily via telephone in a call center environment. This position will work with a team of other Medicare Member Advocates to meet the overall department objectives to enhance the customer experience. This position has work-from-home opportunities but requires occasional on-site work.

Key Responsibilities

• Answer the minimum number of calls for a full eight-hour day as outlined in the Minimum Production and Quality Standards.


• Receive and respond professionally and courteously to all member inquiries regarding eligibility, claims, general coverage questions, Primary Care Physician (PCP), address changes, provider network, and any questions or concerns about their health and prescription drug benefits with VIVA Medicare.


• Document and forward grievances and Part D exception requests to the Appeals & Grievances department according to established policies and procedures.


• Create accurate and timely member documentation concerning all phone calls taken according to departmental operating guidelines.


• Ability to work evening and weekend shifts as needed.

REQUIRED:

• High school diploma or GED


• One year of experience in a call center 


• Excellent oral and written communication skills


• Effective listening and reading comprehension skills


• Above-average data entry skills


• Knowledge of standard office practices and procedures, including the operation of office equipment, including personal computers and word processing, spreadsheets, and presentation programs


• Proper written and spoken English skills including spelling, punctuation, and grammar; basic business arithmetic


• Ability to work with minimal supervision


• Ability to work under pressure from deadlines and goals


• Ability to complete all company-required, job-specific, and departmental training

PREFERRED:

• Some college


• Experience in health or insurance-related call center


• Experience working with the elderly population


• Working knowledge of Medicare, medical terminology, and HIPAA guidelines