Ashlene Acosta

A self-employed Medicare specialist and broker helps individuals understand, select, and enroll in Medicare health plans while operating an independent business. Typical duties include:

• Explain Medicare Parts A, B, C (Medicare Advantage), and D (Prescription Drug Plans).
• Educated clients on Medicare eligibility, enrollment periods, and coverage options, enhancing informed decision-making.
• Assess clients' healthcare needs, prescriptions, doctors, and budget.Self-employed Medicare Specialist and Broker providing personalized Medicare education, plan analysis, enrollment assistance, and ongoing client support. Licensed to represent multiple insurance carriers while ensuring compliance with CMS regulations, maintaining client relationships, generating leads, and managing independent business operations.
• Compare Medicare Advantage, Medicare Supplement (Medigap), and Part D plans from multiple insurance carriers.
• Present suitable plan options based on client needs.
• Explain costs, benefits, provider networks, and coverage limitations.
• Assisted clients with Medicare plan applications and enrollments, ensuring compliance and accuracy in the process.
• Help clients make changes during Annual Enrollment Period (AEP) and other qualifying enrollment periods.
• Ensure applications are complete and compliant with Medicare regulations.
• Maintain required insurance licenses and certifications.
• Follow Centers for Medicare & Medicaid Services (CMS) regulations and marketing guidelines.
• Complete annual carrier certifications and Medicare training.
• Maintain accurate records and protect client privacy according to HIPAA requirements.
• Provided ongoing customer service post-enrollment, addressing inquiries and resolving issues related to coverage and claims.
• Resolve coverage, billing, or claims-related questions.
• Conduct annual policy reviews to ensure clients remain in appropriate plans.
• Generate leads through networking, referrals, seminars, community outreach, and digital marketing.
• Develop relationships with healthcare providers, senior organizations, and community groups.
• Manage a client database and follow-up activities.
• Track commissions and renewals.
• Maintain client records and documentation.
• Manage appointments, scheduling, expenses, and business finances.
• Stay informed about changes in Medicare plans and regulations.

• Respond to incoming calls from providers, members, Blue Cross Blue Shield plans, and internal departments.
• Process and review medical claims accurately and efficiently.
• Handle time-sensitive and special-case claims requiring detailed analysis and attention.
• Review and complete tasks created by other representatives to ensure timely resolution.
• Respond to written correspondence and inquiries from members and providers.
• Complete assignments and special projects requested by supervisors and management.
• Follow established departmental procedures and Blue Cross Blue Shield Association standards.
• Utilize multiple databases and Microsoft Office applications to research and process information.
• Consistently provide excellent customer service while managing multiple priorities.