Member Service Representative

Job Summary

Handling routine member and provider inquiries, the full-time Member Service Representative will assist with benefits, claims, eligibility, and general health plan information while working remotely.

Key responsibilities

• Answer inbound calls from members and providers regarding health plan benefits and inquiries
• Research and provide accurate information to ensure a positive customer experience
• Document all interactions and maintain compliance with HIPAA and healthcare regulations

Required qualifications

• High School Diploma or GED required
• Minimum of one (1) year of customer service or call center experience preferred
• Working knowledge of Medicare and Medicaid programs preferred
• Healthcare, insurance, or related experience preferred
• Strong computer and data entry skills