Medicare Specialist

Southern Maine Agency on Aging (SMAA) is committed to positive long-term outcomes for older adults and their caregivers. We empower older adults, adults with disabilities and their caregivers to live to their fullest potential by providing services, resources and information. At SMAA, we believe that a supportive and inclusive workplace, where everyone feels valued and heard, is key to shaping organizational culture and advancing our work with underrepresented and diverse communities. We were recently voted Best Places to Work in Maine 2024!

Position Summary:

The Medicare Program at SMAA hosts a team of trained State Health Insurance Program (SHIP) Volunteer Counselors that help Medicare beneficiaries and/or their caregivers navigate health insurance options. SMAA’s Medicare Program ensures that all older and disabled Mainers, and their caregivers, have access to free, confidential, and unbiased support in navigating their health insurance options.  

The Medicare Coordinator is a key member of the Medicare team. They work closely with the Medicare Program Manager to lead program administrative tasks, as well as deliver Medicare community education and 1:1 client services in a variety of formats. The ideal candidate enjoys working collaboratively with staff and volunteers to meet the needs of Medicare beneficiaries. Organizational skills and attention to detail are essential for balancing administrative duties while supporting staff and volunteers with Medicare community education. 

Responsibilities:

Reporting to the Medicare Program Manager, the Medicare Specialist will work closely with Medicare Volunteers and staff across the organization.  Responsibilities may include, but are not limited to, the following:

1. Oversees health insurance counseling service-related data entry completed by staff and volunteers. 

2. Performs administrative tasks including: 

• Managing and tracking all incoming calls from clients and caregivers.
• Scheduling appointments for Medicare beneficiaries and/or their caregivers to meet with volunteer counselors as needed. 
• Managing seminar registrations and surveys 
• Running a monthly call log report 
• Working within several platforms such as Simply Book Me, STARS and Wellsky to ensure timely and accurate data management  

3. Provides logistical support to the Medicare Program Manager for group education and 1:1 health insurance services for clients including equipment distribution, scheduling, and Medicare educational materials. 

4. Participates in the Maine Medicare Workgroup, Senior Medicare Patrol (SMP) meetings and Medicare related webinars, under the direction of the Medicare Program Manager.  

5. Serves as primary contact for all Medicare counseling and fraud & abuse cases. Medicare training is provided; these duties will grow over time as Medicare knowledge grows. 

• Assist clients in understanding policy details, coverage options, premiums and benefits.  
• Educate clients about their rights and process for appeals.  
• Answer client questions and follow-up on concerns about medical bills, insurance claims and Medicare notices. 
• Assist directly with complex Medicare and health insurance questions/inquiries in collaboration with service providers such as Legal Services for Maine Elders and the Department of Health and Human Services  
• Review cases for potential waste, fraud and abuse. 

6. Supports the Medicare Program Manager with content for and scheduling of regular volunteer meetings and trainings. 

Qualifications: 

Experience and Skill Requirements:  The following requirements and skills are preferred:

• Personal or professional experience working with older adults preferred.
• Experience working with volunteers preferred. 
• Willingness to develop knowledge of current Medicare rules and practices, as well as benefit and entitlement programs designed to assist low-income older people and adults with disabilities.
• Critical thinker, able to analyze and problem solve to resolve issues of varied levels of complexity.
•  Must be highly organized, able to multi-task and prioritize. Need to be flexible and highly adaptable.
• Proficient in Microsoft Office applications including Word, Excel, and Outlook, and experienced in working with all traditional office equipment.  
• Excellent interpersonal skills for dealing tactfully with staff, clients, and the public, and establishing and maintaining effective working relationships with other employees and the public. 
• Excellent communication skills, both written and verbal.
• Accuracy and attention to detail. 
• Ability, judgment, and initiative to work independently, manage priorities with minimal guidance, and meet deadlines. 
• Must have access to reliable transportation.

Education/Knowledge Requirements: The following education requirements are considered essential:

• Post-secondary education in social work, gerontology or a related field, or the equivalent in work experience, preferred.
• Knowledge of health insurance coverage rules and practices and benefits/entitlement programs a plus. 
• Knowledge of needs, issues, resources, and entitlement programs and services for the elderly a plus.
• Must have or obtain State Health Insurance Program (SHIP) Medicare Certification within the first 6 months of employment; SMAA will support this training.

We list our preferred qualifications and are open to candidates who can demonstrate their experience and/or education that supports their alignment with the skills we are seeking.

Salary and Benefits:  This is a non-exempt position, working 40 hours per week, with an hourly rate of $21.00- $23.00. Benefits are the following for full time.

• Health Insurance (Employer paid at 100% for Employee only plan)
• Vacation time
• Sick time
• 13 holidays per year
• Dental and vision insurance
• Accident and critical illness insurance
• 403B Retirement Plan
• Life insurance, income protection plan, and long-term disability insurance.
• Hybrid work schedule – office/work from home

To Apply:

Please submit your resume and a cover letter explaining why you are the right fit for this position.

The position is open until filled 

SMAA is an equal-opportunity employer

Salary : $21 - $23