Medicare Member Benefits Specialist

at Ameridial Inc.
Location Canton, OH
Date Posted July 11, 2019
Category Default
Job Type Freelance


Job Description

Ameridial is seeking enthusiastic and upbeat customer service representatives to join our member services team.

As a healthcare member service agent you would receive calls from health plan members, non-members, and providers. The main objective is to respond to inquiries/issues from members, providers and facilities regarding benefits, coverage, payment, coding and health service policies and procedures.

Bilingual Spanish speaking positions are available in this department with additional compensation

We offer our dedicated staff the following

  • Excellent starting wages- receive additional compensation PER HOUR for working your scheduled shift
  • Training Incentives- receive training bonuses
  • Medical, Dental, and Vision offered
  • Child Care Discount (there is a day care located across the street from the office!)
  • Paid holidays and casual environment (yes you can wear jeans!)

Essential Responsibilities

  • Acts as customer advocate in providing assistance to resolve callers' issues and problems.
  • Researches and analyzes recurring billing and eligibility problems/complaints to determine root causes and trends.
  • Provides instruction to members for submitting out-of-plan medical claims.
  • Follows through with callers when inquiries/issues cannot be resolved on first contact.


  • At least 2 year’s of previous customer service experience, highly desired in a medical environment or call center environment.
  • Knowledge of Medicare Regulations/Product, ICD-9 and ICD-10 diagnosis, CPT-4, UB82 revenue codes, UB92 revenue coding and procedural coding desired.
  • Excellent telephone manner; ability to handle high volume of calls efficiently and courteously.
  • Previous system user experience in a fast paced highly automated environment required. Strong PC skills required.
  • Demonstrated organizational and problem solving skills.
  • Excellent telephone manner; ability to handle high call volumes efficiently and courteously..


  • Must have the ability to organize simultaneous tasks & be results driven
  • Establishes rapport with callers quickly & speaks in a manner that gets others energized
  • Identifies underlying issues among complex situations or problems.
  • Must have proven ability to work effectively as a team member.
  • Demonstrates urgency to get things done


The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of the personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed