Medicare Specialist

Our client, a renowned organization in the healthcare industry, offers a comprehensive range of individual (Medicare) and group (employee) benefits. They are currently on the lookout for a dedicated and experienced Medicare Specialist to join their dynamic team.

This role is integral to the organization as it involves advising clients on Medicare Plan Options, processing enrollments and claims, and ensuring compliance with federal and state regulations. In addition, the Medicare Specialist will also serve as a liaison between clients, providers, and government agencies to resolve complex eligibility or billing issues.

Medicare Specialist Job Responsibilities

• Providing guidance to clients on Medicare plan options.
• Ensuring compliance with federal and state regulations.
• Processing enrollments and claims while maintaining up-to-date knowledge of Medicare policies and procedures.
• Delivering training to clients or staff as needed.
• Resolving complex eligibility or billing issues.
• Serving as a liaison between clients, providers, and government agencies.
• Supporting the Employee Benefits Team with technical expertise.
• Preparing marketing materials and conducting outreach.
• Handling data entry, client inquiries, and basic claims processing.
• Undertaking strategic planning with Employee Benefits Teams and interpreting regulatory requirements.

Qualifications

• Minimum of 5 years of experience in consulting, processing enrollments and claims, with a deep understanding of Medicare policies and procedures.
• Expertise in compliance with federal and state regulations.
• Proven experience in training clients or staff.
• Ability to resolve complex eligibility or billing issues.
• Experience in working in a team environment; preparing marketing materials, conducting outreach, data entry, and basic claims processing.
• Active WA State Life & Disability Licenses.
• Desirable: AHIP Medicare Training Certification & Designations issued by America’s Health Insurance Plans (AHIP).

If you are a seasoned Medicare Specialist looking for a challenging yet rewarding role, we encourage you to apply. This is an excellent opportunity to be part of an esteemed organization and contribute constructively to the healthcare industry.