Member Services Specialist

Job Summary

Serving as a frontline ambassador for the health plan, the full-time Member Services Specialist will provide high-quality, resolution-focused support to members, providers, and brokers, while navigating healthcare offerings and ensuring first-call resolution in an onsite environment.

Key responsibilities

• Resolve member, provider, or broker inquiries across various health plans, quoting basic eligibility and benefits as needed
• Document call interactions clearly and accurately in the CRM to support audit readiness and coordination
• Participate in progressive training modules to build foundational knowledge in core plan structures and internal workflows

Required qualifications

• High school diploma or equivalent is required
• Basic proficiency in Microsoft Office Suite (Word, Excel, Outlook) and ability to learn proprietary systems quickly
• 0-2 years of customer service experience preferred, ideally in healthcare, insurance, or call center environments