Stars Call Center Representative

About the role

The Stars Call Center Representative will handle inbound and outbound calls supporting the Medicare Stars Program. The role focuses on meeting call volume and quality targets while ensuring accurate documentation and compliance with program guidelines.

Key responsibilities

• Receive and initiate calls aligned with Stars Program strategies and initiatives.
• Evaluate, resolve, and document inquiries from policyholders and providers.
• Forward complex issues to appropriate operational teams for timely resolution.
• Maintain compliance with quality standards, KPIs, and documentation requirements.
• Schedule appointments with physicians and health providers as needed.
• Perform follow‑up actions to ensure service requests are completed and documented.
• Provide administrative support to IPAs, PCPs, and other departments related to Stars initiatives.

Required profile

• High school diploma (or equivalent).
• Minimum three years of customer service experience, preferably in a health‑insurance call center.
• Strong punctuality and adherence to assigned work schedules.
• Ability to follow established operational processes and maintain detailed records.

Required skills

• Proficiency with the Alvaria connection system for call handling and documentation.