Member Service Representative

Role overview Support health plan members by answering inbound questions, researching concerns, and helping resolve issues across a range of service needs. The representative also makes outbound calls when more information or follow-up is needed, while coordinating with colleagues to provide accurate and timely assistance.

Responsibilities - Verify member information and answer general questions. - Investigate and resolve inquiries, involving a supervisor when appropriate. - Contact members to follow up on open issues or gather additional details. - Maintain accurate records and ensure information shared on a member’s behalf is correct. - Manage work queues and meet service quality and productivity expectations. - Communicate with members and internal teams, and complete required training.

Requirements - High school diploma or GED. - At least two years of customer service experience in a call center. - Clear written and verbal communication, active listening, and professional phone manner. - Ability to navigate several systems, follow established procedures, and handle multiple tasks with care. - Strong organization, attention to detail, and problem-solving skills. - Reliability, focus, and time management for remote work.

Nice to have - Associate degree or higher in a healthcare-related field. - More than two years’ experience in a fast-paced call environment, including processing or customer service work. - Familiarity with medical insurance services and administrative systems.

Benefits and work setup The listing specifies a 40-hour work week and non-exempt status. The role is described as remote-capable; it involves extended periods sitting and taking calls, with travel listed at 0–25%.