Member Services Specialist

Role overview A virtual women's and family health organization is hiring a Member Services Specialist to handle its most complex and sensitive member cases. The role blends high-stakes case ownership with day-to-day support volume, balancing phone and written communication across fertility, maternity, parenting, and midlife care programs. The team operates seven days a week, with multiple shift options available in Eastern Time.

Responsibilities - Own complex cases end-to-end, including appeals, denied claims and applications, coverage loss, COBRA issues, deductible disputes, and urgent care needs - Take member phone calls on specialty workflows, including conversations where prior interactions have gone badly - Distinguish between similar-sounding requests (for example, a denial question versus a formal appeal, or a denied application versus a denied claim) and apply the correct workflow - Investigate before replying by pulling full history, identifying where the process broke, and returning with an answer rather than a status update - Communicate coverage, eligibility, and reimbursement rules clearly, without overpromising outcomes - Coordinate cross-functionally with compliance, clinic partners, and benefits administrators when cases require escalation

Requirements - Experience handling complex, sensitive customer or member cases involving money, medical timelines, or both - Strong written and verbal communication skills, with the ability to support members by phone and in writing - Ability to read between the lines of a member request and choose the right workflow - Sound judgment on what can be promised versus what depends on a third party - Comfort working a scheduled shift that may include evenings or weekends - Authorization to work in the United States; remote work is supported across a wide range of states

Nice to have - Background in healthcare, insurance, benefits administration, or a related regulated environment - Familiarity with fertility, maternity, or family-building workflows - Experience using case management or ticketing tools such as Jira

Benefits and work setup - Remote-first policy with tools and culture designed for distributed teams - Access to the organization's full care platform and specialists, including mental health, reproductive health, family planning, and pediatrics - Wellness partnerships supporting whole-self care - Hybrid work options with in-office meals and team collaboration days - 16 weeks of fully paid parental leave plus a new parent stipend (after one year of tenure) - Annual professional development stipend and access to a personal career coach - 401(k) matching with immediate vesting for U.S.-based employees - Comprehensive medical, dental, and insurance plan options