Client Services Representative
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Job Description
Client Services Representative supporting Medicare clients with plan questions, documents, and portal issues. Handling high-volume calls while meeting CMS compliance and quality standards.
Responsibilities:
- Provide exceptional client service
- Handle inbound and outbound follow-ups about Medicare Parts A, B, C (Advantage), and D (Drug) plans
- Resolve questions about coverage, premiums, provider networks, and benefits
- Assist with document requests including ID cards, authorizations, referrals, and financial subsidies
- Troubleshoot portal access, website, and email issues
- Log all interactions accurately in CRM systems
- Escalate unresolved or complex issues to supervisors, benefits specialists, or compliance teams
- Pass quality assurance test calls and adhere to CMS compliance requirements
- Collaborate with the team to support clients
- Work in a high-volume environment handling approximately 40–60+ calls per day
- Meet quality assurance, script adherence, and performance targets
Requirements:
- Minimum of two years in a Client Services role, ideally in healthcare insurance or Medicare
- Strong verbal and written communication, active listening, and empathy
- Computer proficiency with Salesforce, Microsoft Office, and online portals
- Problem-solving skills and ability to handle high call volumes
- Attention to detail and ability to follow scripts, documentation requirements, and compliance metrics
- Cameras required for all training sessions, supervisor meetings, and team engagement
- High school diploma or equivalent
- Comfortable using CRM tools and virtual meeting platforms
- Ability to adapt to schedule changes
- Ability to work independently in a remote environment
- Bilingual capabilities, especially Spanish or other commonly spoken languages, preferred but not required
Benefits:
- Remote work environment
- Virtual training sessions, supervisor meetings, and team engagement
- Ongoing coaching sessions
- Structured schedule with mandatory training and periodic coaching
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