Healthcare Member Guide

Job Summary

A company is looking for a Member Guide Associate to support members through their healthcare journey.

Key Responsibilities

• Serve as the first point of contact for member and provider inquiries, providing support with professionalism and empathy
• Manage claims inquiries by documenting, researching, and resolving issues within established service level agreements
• Identify trends in inquiries to recommend process improvements and enhance customer experience

Required Qualifications

• Minimum of 2 years of experience in health plans, benefits, claims management, or customer service
• Strong fluency in health insurance terminology and the ability to explain it clearly
• Proficiency with Google Workspace, CRM/ticketing systems, and claims portals
• Ability to work weekend shifts
• Experience in a fast-moving, ambiguous environment with a focus on delivering exceptional member experiences