Kansas Medicare Advantage Specialist

Job Summary

Providing exceptional customer service, the full-time Kansas Medicare Advantage Specialist will process and resolve member appeals, grievances, and inquiries while ensuring compliance with regulatory guidelines, with the option to work remotely or onsite.

Key responsibilities

• Process Medicare Advantage member and provider appeals, grievances, and complaints to meet regulatory standards
• Analyze and interpret MA benefit offerings and corporate policies to address complex issues
• Develop and maintain effective relationships with internal and external stakeholders for timely issue resolution

Required qualifications

• High school diploma or equivalent required; college coursework in communications or medical fields preferred
• Minimum 2 years of customer service experience required
• At least 3 years of experience in Medicare Advantage or Medicaid Appeals and Grievances required
• Preferred experience in call center or production-based customer service
• Familiarity with Blue Plan processes preferred