[Remote] Medicare Call Center Rep - PUERTO RICO at Humana

Puerto Rico

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Must currently reside in Puerto Rico
2 years of customer service experience
Demonstrated experience with providing strong customer service and attention to detail while actively listening
Prior experience managing multiple or competing priorities, including use of multiple computer applications/systems simultaneously
Proficiency with Microsoft Office applications, particularly Outlook and Teams
Prior experience effectively communicating with customers verbally and actively listening to their needs
Must be fluent in English with the ability to speak, read, and write in that language without limitations or assistance (Language Proficiency Assessment in English/Spanish required if selected)
Willingness to commit to the position for 12 months before applying to other Humana opportunities outside of Individual or Group Medicare
Ability to work required schedule: virtual training (8:00 AM to 4:30 PM EST/9:00 AM to 5:30 PM AST, Mon-Fri for 10-12 weeks, no time off except Humana holidays); post-training 8-hour shift (7:45 AM-9:00 PM ET/8:45 AM-10:00 PM AST, Mon-Fri); some weekends/OT especially Oct-Mar; on time with camera on for training/meetings

Responsibilities

Address incoming telephone, digital, or written inquiries from Medicare members
Provide resolution or pathway to resolution on each call while delivering a perfect call experience
Handle customer needs including complex benefit questions, resolving issues, and educating members
Handle 40+ inbound calls daily in a fast-paced, high-volume call center environment
Record details of inquiries, comments, complaints, transactions, or interactions, and take action accordingly
Escalate unresolved and pending customer grievances
Perform varied activities and moderately complex administrative/operational/customer support assignments, including computations
Work on semi-routine assignments within defined parameters, with some latitude over prioritization/timing under minimal direction
Follow standard policies/practices with opportunity for interpretation/deviation and independent discretion

Skills

Customer Service

Call Center

Medicare

Inbound Calls

English Fluency

Spanish Fluency

Telephone Support

Digital Inquiries

Issue Resolution

Member Education

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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