Health Plan Specialist

Health Plan Specialist

We are looking for a Health Plan Specialist to support members through high-volume inbound phone interactions and deliver thoughtful, accurate assistance with coverage, billing, and enrollment questions. The person in this role will help guide members through complex situations, document each interaction carefully, and provide dependable service during busy enrollment periods. Success in this position requires strong communication, sound judgment, and the ability to manage multiple systems while maintaining a detail-oriented and member-focused approach.

Responsibilities

• Handle a large volume of inbound calls from Medicare members and respond to questions related to plan benefits, invoices, eligibility, and enrollment matters.

• Take full ownership of each member inquiry from initial contact through final resolution, ensuring all actions and outcomes are recorded accurately.

• Research issues using internal systems and online resources to provide clear answers and timely follow-up on outstanding concerns.

• Support members facing more involved or sensitive situations by listening carefully, showing empathy, and explaining next steps in an understandable way.

• Maintain a respectful, service-driven tone on every interaction while meeting quality and productivity expectations during peak enrollment periods.

• Navigate multiple applications and dual-screen workstations efficiently to verify information, complete documentation, and resolve concerns without unnecessary delays.

• Participate in virtual training, team collaboration sessions, and ongoing coaching activities while remaining visible and engaged on camera as required.

• Adhere to remote work standards by using company-issued equipment and sustaining a distraction-free home office environment with reliable hard-wired internet connectivity.

• High school diploma or equivalent work experience in a related setting.

• At least 2 years of experience in a call center environment.

• Demonstrated customer service background, preferably within health insurance or Medicare-related operations.

• Ability to communicate clearly and effectively in both verbal and written formats.

• Proficiency with Microsoft Office, multi-screen computer setups, and working across several applications at once.

• Strong problem-solving skills with the ability to assess complex member concerns and provide accurate solutions.

• Reliable attendance and the flexibility to work any assigned shift within the Monday through Friday operating window.

• Must have stable high-speed hard-wired internet access via ethernet and a well-organized remote workspace suitable for video-based training and meetings.

• TalentMatch®

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• All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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