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Description

Summary Description:

Under the general direction of the Supervisor, performs a variety of functions including responding to all member inquires through incoming phone calls, faxes, email and written correspondence, providing accurate responses in a timely manner. Accountable for providing a positive member experience by consistently showing professionalism, empathy and respect in their interactions with both internal and external customers. In accordance with established policies and procedures, performs a variety of administrative and member support tasks. Responsible for contributing to meeting and/or exceeding the service level goals and compliance in accordance with corporate performance guidelines and standards set forth by the Medicare Division and the Centers for Medicare and Medicaid Services. Accountable for meeting individual performance goals established by management.

Essential Resource Responsibilities / Accountabilities:

Level I

- Participates in the training needed to learn regulations, legacy systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job

- Responsible for maintaining accurate and up-to-date knowledge of all Medicare Advantage regulations and possess the ability to communicate to members in a clear and concise manner to ensure understanding of the products

- Including but not limited to competitive plans, health care financing, CMS, and trends and concepts that impact managed health care

- Demonstrates a thorough understanding of the Grievance & Appeal process and timeframes

- Demonstrates a complete and thorough understanding of all subscriber agreements, amendments, marketing materials, and program

- Researches, interprets and responds to inquiries from internal and external customers, business partners and special groups concerning our products, services and policies in accordance with CMS, NCQA and legislative requirements

- Continues to develop necessary skills to expertly, accurately and efficiently resolve customer inquiries in an organized manner, resulting in acceptable accuracy and production levels, and retention of subscriber contracts

- Deals effectively with upset customers in an empathetic and professional manner and takes responsibility for conflict resolution

- Responds to customers in a professional, efficient manner to encourage public acceptance of corporate products, services, and policies

- Identifies patterns generated by external and internal action effecting customer satisfaction

- Identifies and follows through on potential issues affecting the insurance industry

Project based role for open enrollment:

e*The main requirements are a sales experience and familiarity with Medicare, with a preference for candidates who already have the required licenses.

*The role involves assisting walk-in customers, reviewing plan changes, and helping them find appropriate Medicare coverage. No outbound sales calls.

*Performance will be measured based on application processing accuracy, not sales targets.

*The candidates will be responsible for triaging customers, reviewing product changes from 2025 to 2026, and providing a good customer experience.

*Team will be assisting existing customers who have been disrupted by plan changes, helping them find a new plan that covers the services and pharmaceuticals they need.

Minimum Resource Qualifications:

Level I

- Post-secondary education with the equivalent of 2-4 years formal education/training and/or public business experience

- A Bachelor’s degree is preferred

- Effective and diplomatic communication skills including oral, written and listening- Organizational, reasoning and problem solving skills

- Strong keyboarding and PC Skills required

- Knowledge of coverage and lines of business products, services and policies

- Medical terminology is desirable

Skills

Customer service

Help desk

Support

Customer support

Medicare

Medicare insurance

Additional Skills & Qualifications

NYS Life, Accident & Health License required in order to sell products directly to consumers.

Medicare Direct Pay Product sales experience preferred.

Experience Level

Entry Level

Pay and Benefits

The pay range for this position is $18.00 - $18.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Rochester,NY.

Application Deadline

This position is anticipated to close on Jul 23, 2025.

h4>About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.