Remote Bilingual Medicare & Medicaid Eligibility Specialist (Advocate)

For many Medicare members, a single phone call with our team can mean potentially saving on Medicare Premiums. If you find deep satisfaction in solving complex problems and advocating for others, your mission starts here.

Compassionate Conversations: Make and receive calls with members needing to apply for or obtain or retain Medicaid, Medicare Savings Programs (MSP), and Low-Income Subsidies (LIS). The "Human Translator": Determine if individuals are eligible for Medicaid or LIS benefits through a series of simple questions. When needed, explain complex regulations and eligibility requirements in simple, warm, and patient terms. Application Mastery: Gather and verify sensitive personal and financial details to ensure 100% accurate enrollment and recertification. Regulatory Standards: Maintain strict adherence to HIPAA, state regulations, and company compliance standards. Database Navigation: Simultaneously manage multiple software systems and databases to track member progress and documentation. Schedule will be Monday to Friday, 11am to 7:30pm EST (9am to 5:30pm MST)

The Ideal Advocate (Who You Are) You are the person friends and family turn to when they need help with something complicated.

Fluent in Spanish (speak, read, write) Experience: 2–3 years in healthcare, eligibility screening, case management, or high-touch customer service. Subject Matter Interest: Knowledge of Medicaid, Medicare, SCHIP, or Special Needs Plans (SNP) is a major plus. Tech-Savvy: You are comfortable navigating multiple screens, Microsoft Teams, and Outlook while talking and typing, maintaining a warm conversation and documenting information in real time. Patience: You remain calm and professional, when faced with obstacles you see these moments as opportunities to build trust. Critical Thinker: You can manage difficult conversations and use probing questions to clarify information and find solutions.

The Reality of the Role (Transparency Matters) To thrive in this position, you should enjoy a structured, performance-driven environment.

High-Volume Engagement: This is a phone-based role. You will spend your day making and receiving calls. Scripted Excellence: To ensure total compliance, you will work within well-defined procedures. Your creativity comes from your tone and empathy while following the process. Goal-Oriented: You will be expected to meet daily and weekly production and quality goals. Efficiency allows us to help more people.