Medicare Member Engagement Representative Encode Inc

•5.0 Akron, OH Job Details Contract $20

•$21 an hour 3 days ago Qualifications Insurance products customer support Customer retention Medicare Phone communication Health insurance policy knowledge Client rapport building CMS Regulatory compliance In-person customer service Health insurance customer support High school diploma or GED CMS regulatory compliance Insurance regulation Medicare regulations Customer engagement Computer skills Associate's degree Health Insurance License Time management Client interaction via phone calls

Full Job Description Medicare Member Engagement Representative Job Title:

Member Engagement Representative

•

Medicare Location:

Akron, Ohio Work Address:

1200 East Market Street, Akron, OH 44305

Job Type:

Long-Term Assignment /

Contract Contract Dates:

September 28, 2026

•December 31, 2026

Schedule:

Monday-Friday, 8:00 AM-5:00

PM Weekends:

No weekends

Work Setting:

100%

In-Office Openings:

6

Health Insurance License:

Preferred, but not required

Interview:

Microsoft Teams ASAP Start:

Yes Position Summary The Medicare Member Engagement Representative will provide personalized customer service and support to Medicare beneficiaries by phone and in person. This position will assist members with Medicare Advantage plan information, plan changes, enrollment questions, network and pharmacy inquiries, and retention initiatives. The representative will work closely with Medicare members to understand their needs, explain available plan options, and assist with plan changes while strictly following CMS regulations, approved scripts, and company compliance requirements. Key Responsibilities Handle Medicare Advantage plan changes over the phone using compliance-approved scripts. Provide accurate information regarding Medicare Advantage plans, benefits, networks, pharmacies, and plan options. Assist Medicare beneficiaries in selecting an appropriate plan based on their needs and preferences. Complete plan change requests from one SummaCare MA-PD plan to another. Communicate clearly with members throughout the enrollment and plan-change process. Make outbound calls to Medicare members regarding plan, network, or benefit changes, particularly during AEP. Track and follow up with members who may be at risk of disenrollment. Support member retention and outreach programs. Document all member interactions and calls accurately. Maintain records of plan change requests and other required administrative information. Assist with presentations of plan benefit information to individuals or groups when needed. Educate members and prospective beneficiaries about available products and enrollment options. Ensure member questions and concerns are addressed professionally and accurately. Follow all CMS Medicare Advantage marketing, enrollment, and compliance requirements. Maintain required reporting and database systems. Perform other administrative duties assigned by management. Required Qualifications High School Diploma or GED required. Associate's or Bachelor's degree preferred. Minimum 2 years of experience in a call center, customer service, or support role within the health insurance industry. Experience working directly with Medicare beneficiaries is required. Understanding of Medicare and health insurance compliance. Working knowledge of Medicare plans, plan design, and benefits. Strong understanding of federal and state regulatory requirements and Medicare marketing guidelines. Excellent verbal and telephone communication skills. Strong listening, critical-thinking, and problem-solving abilities. Ability to multitask while navigating multiple computer systems. Ability to work independently as well as within a team. Strong organizational and time-management skills. Ability to handle difficult conversations and effectively build member confidence and trust. Ability to interact respectfully and professionally with Medicare beneficiaries. Preferred Qualifications Active health insurance license preferred but not required. Two or more years of health insurance industry experience strongly preferred. Previous Medicare Advantage enrollment/member engagement experience preferred. Experience with CRM and member-management systems preferred.

Systems / Technical

Skills Candidates should be comfortable operating a computer while communicating with members and using multiple systems simultaneously, including: MACESS Member Documentation System Plan Central Salesforce CRM SummaCare website Telephone/communication systems Training Requirement The selected candidate must successfully complete required SummaCare plan and product training before the Open Enrollment season and achieve a minimum passing score of 90% . Work Environment In-office position in Akron, Ohio. Monday through Friday, 8:00 AM-5:00 PM. No weekend requirement. Frequent interaction with Medicare beneficiaries. Work may involve moderate stress, interruptions, distractions, and complex member situations. Occasional travel between locations during the workday may be required. Interview Process Microsoft Teams interview required. Candidates should provide their available interview dates and times when submitted. Ideal Candidate The ideal candidate will have 2+ years of health insurance customer service/call center experience , direct experience working with Medicare beneficiaries , and a strong understanding of Medicare Advantage and CMS compliance requirements . Candidates with an active health insurance license are preferred and may qualify for a higher bill rate.

Pay:

$20.00

•$21.00 per hour Expected hours: 40.0 per week Application Question(s): Minimum 2 years of experience in a call center, customer service, or support role within the health insurance industry. Experience working directly with Medicare beneficiaries is required. health insurance licensed

Education:

High school or equivalent (Required)

Experience:

call center: 2 years (Required) customer service: 2 years (Required) health insurance industry: 2 years (Required) Medicare beneficiaries: 2 years (Required)

License/Certification:

Health Insurance License (Required)

Work Location:

In person