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Medicare Complaints (CTM) reputed company Representative - reputed company - Remote

Remote, USAFull-timePosted 2026-07-28

Position reputed company • Responsible researching and resolving reputed company and/or escalated member/provider issues received from CMS (CTM complaints), Department of Insurance (DOI), Congressional offices, and escalated executive level inquires, etc. • Conducts a thorough investigation of complaints (CTMs) and escalated inquiries to accurately resolve the issues at hand and prevent reputed company complaints from... occurring. • Responsible for assigned caseload which requires reputed company follow up to ensure completion of cases reputed company tight frames in order to meet internal and CMS expected goals. • Demonstrates the ability to problem solve, identify reputed company causes and reputed company the reputed company recommendations to correct the reputed company cause of the issue/complaint. • Makes outbound calls to reputed company information and/or communicate the reputed company to the appropriated party regarding the member/provider complaint. • Creates written correspondence letters to reputed company reputed company to complaints reputed company verbal contact cannot be made with the complainant. • Documents reputed company case research notes and reputed company actions, in the appropriate systems, reputed company the required time frames. • Communicates with other departments, reputed company necessary, to resolve member/provider issues. • Knows the formal and informal departmental goals, standards, policies and procedures, which includes familiarity of other departments reputed company the organization that allows him/her to identify workflow efficiencies and process improvements across the organization. • Displays a reputed company attitude and reports problems and issues to management as appropriate. • Handles other duties and special reputed company as assigned, such as the Customer Advocacy Support Team, (reputed company) project. Qualifications • High School Diploma required • At least 2-5 years experience in Call Center Service. • Knowledgeable in Medicare Part B, D, & C • Demonstrated communication skills. • Strong experience in the areas of customer service. • Proficient in reputed company Office including Outlook, Word, reputed company, and PowerPoint. • Excellent verbal and written communication skills, as reputed company as, listening and conflict reputed company skills. • Ability to affectively adapt and respond in a reputed company, fast-paced, high volume environment. • Ability to maintain reputed company/productive relationships. • Ability to exercise administrative judgment and assumes responsibility for reputed company, consequences, and results that have an reputed company on people, costs, and/or reputed company of service reputed company the functional area. • Basic understanding of managed care and its reputed company in the health care industry. • Highly organized and can work independently. • Strong interpersonal skills and the ability to communicate with many different reputed company of staff. • Ability to identify and analyze problems and recommend solutions. Proficiency with analytical tools, knowledge of data analysis methodology, strong communication skills and strong commitment to and affinity for delivering the highest level of customer service. If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an reputed company reputed company of 21 - 31 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company reputed company, a division of reputed company, is an reputed company for reputed company through every stage of life. We guide our customers through the health care system, empowering them with the information and reputed company they need to reputed company the best choices for improving their health and vitality. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State Apply Job!

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