Medicare Advantage Customer Service Specialist

Job Summary

A company is looking for a Customer Service Specialist - Medicare Advantage.

Key Responsibilities

• Accurately process incoming prior authorization requests following CMS guidelines and internal protocols
• Triage and route incoming faxes to the appropriate teams and systems efficiently
• Communicate with providers and internal teams to clarify requirements or gather missing documentation

Required Qualifications

• High school diploma or equivalent (Associate's degree or healthcare certification preferred)
• At least 2 years of experience in healthcare customer service, prior authorization, or medical office administration
• Familiarity with Medicare Advantage and CMS regulations preferred
• Proficiency in Microsoft Office and comfort with healthcare systems (fax platforms, CRM, PA portals)
• Ability to work independently while staying connected to a collaborative team