Member Services Representative

Job Summary

Serving as a frontline ambassador for the health plan, the full-time Member Services Representative will deliver high-quality, resolution-focused support to members, providers, and brokers across multiple lines of business, with an emphasis on first-call resolution and navigating healthcare offerings.

Key responsibilities:

• Resolve inquiries from members, providers, or brokers regarding Health Exchange, US Family Health Plan, and NCHD, focusing on eligibility and benefits
• Document call interactions in the CRM accurately to support audit readiness and operational excellence
• Guide members through the CHRISTUS website and individual member portal while advocating for their needs

Required qualifications:

• High school diploma or GED is required
• Experience in customer service, preferably in healthcare, insurance, or call center environments
• Basic proficiency in Microsoft Office Suite and ability to quickly learn proprietary systems
• Ability to work remotely and manage tasks independently while adhering to remote work protocols
• Demonstrated understanding of member rights and responsibilities, and compliance with HIPAA regulations