Best Practices, Call Centers, Call Volume, Communication Skills, Content Management Systems (CMS), Customer Relationship Management (CRM) Systems, Documentation, Health Insurance, Leadership, Medicare, Metrics, Needs Assessment, Operational Support, Operations Processes, Problem Solving Skills, Process Flow, Scripting (Scripting Languages), Trend Analysis
remote in any state except NY, CA, HI or AK
Role Purpose:
The Eligibility Lead Representative is a licensed individual who is responsible for providing real-time operations support to licensed agents who are responsible for assisting existing members with explaining their plan benefits and or changing their existing plan. This role focuses on workflow support, system navigation assistance, issue escalation, & operational efficiencies during the Annual Enrollment Period.
Key Responsibilities:
Managing Attendance and ensure Agents are adhering to work schedules.
Ensuring the team is meeting service levels as mandated by CMS
Listening to calls to ensure Agents are following the CMS approved script and adhering to work/process flows.
Track and trend missing compliance metrics to determine training needs and report to Manager.
Provide real-time agent support
Serve as a first point of contact for agent questions
System navigation
Assist agents with understanding products, eligibility and the enrollment process.
Identify real-time operational issues and escalate to manager.
Ensure proper documentation within CRM tool
Act as a communication liaison between agents & leadership
Sharing best practices
Reinforce training
Take calls as needed
Must be available to work evenings, weekends and holidays and commit to and adhere to a phone schedule and shift. Standard shifts are anywhere between 8:00am and 8:00pm all time zones and are subject to change based on staffing and business needs.
Qualifications
Active Health Insurance License
Bachelor s degree, preferred
Experience in Medicare Advantage and Medicare Supplement plans
Call center environment experience.
Clear, concise communicator with strong problem-solving skills
Demonstrated reliability during peak call volume periods
Previous Supervisor or Lead experience.I
Integrated Resources, Inc