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, handling inquiries across multiple healthcare offerings, including the Health Exchange and US Family Health Plan.

Key responsibilities:

• Resolve member, provider, or broker inquiries during initial contact, ensuring first-call resolution and accurate documentation in the CRM
• Explain core benefits and eligibility, guiding members through the CHRISTUS website and their individual member portal
• Maintain performance expectations, including call handling metrics and participation in assigned projects to support team goals

Required qualifications:

• High school diploma or GED is required
• Experience in customer service, preferably in healthcare, insurance, or a call center environment
• Basic proficiency in Microsoft Office Suite and ability to learn proprietary systems quickly
• Ability to work remotely with reliable internet access and adhere to remote work protocols
• Demonstrated understanding of member rights and responsibilities, maintaining HIPAA compliance during interactions