FL Medicaid Contact Center Representative

Florida, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Candidates must reside in Florida and possess a minimum of one year of customer service experience. Proficiency in Microsoft Office applications, particularly Outlook and Teams, is required, along with strong technical skills for navigating multiple software systems, email, chats, and databases. Excellent interpersonal skills, the ability to organize simultaneous tasks, and meeting monthly call, attendance, and performance metrics are also necessary. A willingness to commit to the role for twelve months before applying for other positions is required.

Responsibilities

Contact Center Representatives will provide coverage for Eastern Time Zone hours, handling up to 75 calls daily from Florida Medicaid customers regarding their health benefits. Responsibilities include supporting outbound call campaigns, assisting members with PCP changes, locating providers, understanding benefit coverages, processing authorizations, addressing provider claims inquiries, handling grievances and appeals, and providing support for transportation and pharmacy needs.

Skills

Customer Service

Microsoft Office

Outlook

Teams

Chat

Typing

Database Navigation

Interpersonal Skills

Task Organization

Call Center

Healthcare Benefits

Provider Locating

Benefit Coverages

Authorizations

Claims Inquiries

Grievances

Appeals

Transportation Support

Pharmacy Support

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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