Medicare Agent Support Specialist {167039}

Medicare Agent Support Specialist {167039}

Location: Onsite - Franklin, TN 37067
Schedule: Monday–Friday | 8:00 AM – 5:00 PM CT
Work Model: Hybrid – Onsite 3 days per week (flexible days)
Pay Rate: $16.79/hr

Position Summary

Serves as a primary resource for agent and customer support within the Medicare health market. This role supports field sales agents, brokers, and internal teams by handling prior authorizations, appeals, benefit inquiries, and case documentation.

This is a fast-paced, call center environment requiring strong insurance knowledge, attention to detail, and the ability to manage multiple systems simultaneously. The Specialist educates, consults, and guides agents to enhance their understanding of Medicare products, tools, and services while delivering exceptional service.

Key Responsibilities

• Process prior authorizations and appeals in accordance with program guidelines
• Handle inbound and outbound calls professionally and efficiently
• Explain prescription drug benefits, reimbursement structures, and Medicare plan details
• Document cases clearly and accurately using internal systems
• Navigate multiple software applications while managing live calls
• Support agents with sales inquiries and product guidance
• Complete sales orders and material requests
• Educate agents on self-service tools and agent support websites
• Build and maintain strong relationships with field sales teams and program partners
• Track all client interactions, events, and outcomes in appropriate systems
• Participate in cross-training to support all departmental roles
• Assist supervisors and managers with team support initiatives
• Collaborate cross-functionally to improve service delivery

Top 3 Required Skill Sets

1. Prescription Drug Reimbursement & Insurance Knowledge

• Understanding of Commercial, PBM, Medicare (Parts A/B/C/D), LIS, and specialty pharmacy
• Ability to explain benefit structures clearly to agents or customers

2. Strong Communication & Customer Service Skills

• Experience handling inbound and outbound calls
• Clear and accurate case documentation
• Professional communication with agents, internal teams, manufacturers, and patients
• Ability to educate and problem-solve effectively

3. Multitasking, Organization & Systems Navigation

• Manage multiple cases and systems simultaneously
• Maintain consistent and detailed documentation
• Operate multiple software tools efficiently in a fast-paced setting

Required Qualifications

• Verifiable High School Diploma or GED
• 1–3 years of customer service experience (phone-based preferred)
• Strong verbal and written communication skills
• Basic computer proficiency
• Ability to read, comprehend, and present information clearly
• Effective problem-solving and decision-making skills
• Ability to work independently with minimal supervision

Preferred Qualifications

• Insurance or Medicare experience
• Knowledge of prescription drug reimbursement processes
• Experience with CRM or case management systems (Salesforce, NaviNet, payer portals, etc.)
• Associate degree

Physical & Work Environment

• Climate-controlled, smoke-free office environment
• Ability to sit or stand for 7–10 hours per day
• May require occasional lifting up to 25 lbs
• Extended hours may be required as needed
• Close vision, color vision, and focus adjustment required
• Ability to hear normal voice sounds