Eligibility Lead Representative

Eligibility Lead Representative remote in any state except NY, CA, HI or AK Role Purpose: The Eligibility Lead Representative is a licensed individual who is responsible for providing real-time operations support to licensed agents who are responsible for assisting existing members with explaining their plan benefits and or changing their existing plan. This role focuses on workflow support, system navigation assistance, issue escalation, & operational efficiencies during the Annual Enrollment Period. Key Responsibilities: Managing Attendance and ensure Agents are adhering to work schedules. Ensuring the team is meeting service levels as mandated by CMS Listening to calls to ensure Agents are following the CMS approved script and adhering to work/process flows. Track and trend missing compliance metrics to determine training needs and report to Manager. Provide real-time agent support Serve as a first point of contact for agent questions System navigation Assist agents with understanding products, eligibility and the enrollment process. Identify real-time operational issues and escalate to manager. Ensure proper documentation within CRM tool Act as a communication liaison between agents & leadership Sharing best practices Reinforce training Take calls as needed Must be available to work evenings, weekends and holidays and commit to and adhere to a phone schedule and shift. Standard shifts are anywhere between 8:00am and 8:00pm all time zones and are subject to change based on staffing and business needs. Qualifications Active Health Insurance License Bachelor s degree, preferred Experience in Medicare Advantage and Medicare Supplement plans Call center environment experience. Clear, concise communicator with strong problem-solving skills Demonstrated reliability during peak call volume periods Previous Supervisor or Lead experience.