Member Experience Specialist
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Job Summary
Serving as the first point of contact for members and healthcare providers, the full-time remote Member Experience Specialist will deliver high-quality support by resolving benefit, eligibility, and claims-related inquiries while ensuring an exceptional service experience.
Key responsibilities
- Answer inbound calls from members and providers professionally and courteously
- Provide accurate information on benefits, eligibility, claims status, and network participation
- Research and resolve complex inquiries by collaborating with internal departments
Required qualifications
- Experience with innovative health insurance plan designs, including Reference-Based Pricing (RBP)
- Familiarity with HIPAA, CMS, or managed care guidelines
- Strong commitment to accuracy and attention to detail
- Ability to prioritize workload effectively in a fast-paced environment
- Bilingual skills (especially Spanish) are a plus
Complete Job Description
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