Job Overview
Location
Remote
Job Type
Full-time
Category
Customer Success
Date Posted
April 16, 2026
Full Job Description
đź“‹ Description
- • As a Medicare Member Services Representative for WVU Medicine’s Peak Health team, you will serve as a vital point of contact for Medicare Advantage members and providers, ensuring accurate information delivery and timely resolution of inquiries to support member satisfaction and plan integrity.
- • Day-to-day responsibilities include handling inbound and outbound calls to address member questions, verify information, resolve issues related to Medicare benefits and claims, maintain communication channels, and escalate complex cases when necessary while adhering to quality and production standards.
- • You will join the Peak Health Claims Operations team within WVU Medicine, a mission-driven healthcare organization committed to delivering innovative, high-quality Medicare Advantage plans through the Peak Advantage program, serving members across West Virginia and beyond.
- • This role offers the opportunity to deepen your expertise in Medicare operations, claims processing, and CMS guidelines while developing strong customer service, problem-solving, and systems navigation skills in a structured, supportive remote environment.
🎯 Requirements
- • High school diploma or equivalent
- • One (1) year of experience handling Medicare claims or related healthcare customer service
- • Excellent written and oral communication, customer service, and telephone etiquette skills
- • Ability to work remotely with self-motivation, reliability, and effective time management
- • Familiarity with medical insurance processes and administrative systems such as Microsoft Office and EPIC
🏖️ Benefits
- • Remote work flexibility with rotating weekend shifts
- • Comprehensive training programs to build proficiency in Medicare services and systems
- • Opportunity to work within a respected healthcare organization (WVU Medicine) focused on member care and innovation
- • Structured 40-hour workweek with defined shifts between 7:30 am – 8:00 pm Monday–Friday
- • Exposure to healthcare operations and claims processing with potential for career growth in member services
Skills & Technologies
About West Virginia University Hospitals, Inc.
West Virginia University Hospitals is the clinical enterprise of West Virginia University, operating a network of academic medical centers, community hospitals, and outpatient clinics across West Virginia. It provides tertiary and quaternary care, medical education, and research, anchored by J.W. Ruby Memorial Hospital in Morgantown. Services include cancer, heart, trauma, pediatrics, and behavioral health. The system serves as the state’s largest employer and leads rural health initiatives, telemedicine, and graduate medical training programs. Governance is through West Virginia University Health System, a tax-exempt, nonprofit subsidiary of the university.
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