Member Services Representative

Job Summary

Providing phone-based customer service support, the full-time Member Services Representative will assist health plan members with benefits, eligibility, claims, and general inquiries while transitioning to a remote environment after training.

Key responsibilities:

• Handle high-volume inbound member calls
• Assist with benefit, claims, provider, pharmacy, appeal, and grievance inquiries
• Document interactions accurately while maintaining HIPAA/PHI compliance

Required qualifications:

• Minimum 5 years of healthcare experience, preferably in Medicare advantage plans or member services
• Ability to work independently in a remote environment after training
• Strong technical skills to troubleshoot connectivity issues and set up equipment
• Experience navigating multiple systems effectively