Member Service Representative

Accountabilities: Handle inbound member calls and provide accurate, courteous assistance across a broad range of healthcare and membership-related questions.

Verify member information and ensure that information provided or collected is accurate and complete.

Research, troubleshoot, and resolve member inquiries and issues while creating a seamless service experience.

Make outbound calls when necessary to provide updates, resolve outstanding issues, or gather additional information.

Maintain consistent communication with members and internal and external stakeholders throughout the resolution process.

Escalate complex or unresolved issues to the appropriate level of supervision when required.

Maintain accurate member documentation, records, work queues, and timekeeping information.

Meet established productivity, quality, service, and queue-management standards.

Participate in required training and demonstrate proficiency with applicable systems, processes, and procedures.

Navigate multiple systems simultaneously while maintaining accuracy and a high level of customer service.

Apply established guidelines and procedures to identify solutions, improve efficiency, and enhance member satisfaction.

Perform additional duties and responsibilities as assigned by management.

Requirements:

High school diploma or GED required.

At least 2 years of customer service experience in a call center environment.

Experience working in a fast-paced customer service or processing environment is preferred.

Experience in healthcare or familiarity with medical insurance processes is preferred.

An associate degree or higher in a related healthcare field is a plus.

Excellent verbal and written communication skills, including strong telephone etiquette and active listening.

Strong interpersonal and customer service skills, with the ability to communicate clearly, concisely, and compassionately.

Strong attention to detail, organization, multitasking, and record-management abilities.

Critical-thinking and problem-solving skills, with the ability to follow established methods while identifying appropriate solutions.

Ability to follow direction, organizational policies, procedures, and service standards.

Working knowledge of administrative and clerical processes, including word processing and managing files and records.

Familiarity with Microsoft Office applications and the ability to learn and navigate multiple software systems simultaneously.

Experience with healthcare or electronic medical record systems such as EPIC is beneficial.

Ability to work effectively in a remote environment with strong self-motivation, reliability, focus, and time-management skills.

Ability to sit and handle telephone calls for extended periods.

Ability to lift approximately 10–25 pounds and accommodate occasional travel of up to 25%.

Benefits:

Full-time, 40-hour workweek with a daytime schedule.

Fully remote work environment.

Opportunity to contribute to a healthcare mission focused on improving the member experience.

Structured training and opportunities to develop proficiency in healthcare service processes and systems.

Collaborative environment with support from management and peers.

Exposure to healthcare membership services, customer support, and issue-resolution processes.

Non-exempt position with compensation and benefits determined by applicable employment policies.

Workplace accommodations are available for qualified individuals with disabilities.

How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best!  Why Apply Through Jobgether? 

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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